Abstract TP15: Long-term Magnetic Resonance Angiography Follow-up of Recanalized Vessels After Mechanical Clot Extraction
Objectives: Endovascular treatment provides a therapeutic option for acute ischemic stroke patients who are ineligible for, or who do not respond to intravenous thrombolysis. Higher rates of recanalization by mechanical clot extraction device were reportedly associated with better clinical outcome, but the long-term patency of recanalized vessel is unknown.
Methods: We retrospectively evaluated magnetic resonance angiography (MRA) at 24-hour and 3-month after the endovascular treatment in consecutive acute stroke patients who were treated with mechanical clot extraction device between Oct. 2010 and May 2012 in our institution.
Results: Fourty-six patients received endovascular treatment for acute ischemic stroke and 35 were treated with mechanical clot extraction devices, Merci and/or Penumbra system, with or without adjunctive therapy. Mean age was 69±12 years, baseline median National Institutes of Health Stroke Scale score was 15 (8 to 24), and occluded vessels were the internal carotid artery in 34%, middle cerebral artery (MCA) in 54%, and vertebro-basilar artery in 11%. Successful recanalization, defined as Thrombolysis In Myocardial Infarction II or III perfusion, was obtained in 32 (91%) patients. During 24-hour after the treatment, reocclusion of the treated vessel was observed in 4 (12.5%) patients. Of 28 eligible patients, 21 (75%) patients had 3-month MRA follow-up. None of the patients had reocclusion, but clinically silent diffuse stenosis was observed in 2 (9.5%) patients. Statistically significant predictors were not identified, but both of the patients were MCA occlusion treated with Merci retriever.
Conclusion: In this study, late stenosis was observed in the MCA on 3-month follow-up MRA. Long-term follow-up seems to be useful to follow the recanalized vessels, especialy when mechanical devices were used.
- © 2012 by American Heart Association, Inc.