Abstract T P34: Residual Contrast Enhancement of Middle Cerebral Artery on Non-contrast Ct (ncct) After Endovascular Treatment in Ischemic Stroke Patients
Background: Residual contrast enhancement of cerebral arteries is frequently visualized on follow up non-contrast CT (NCCT) after endovascular treatment in acute ischemic stroke and may represent distal microvascular no-reflow phenomenon.
Objective: To evaluated the prevalence of and correlation between post- endovascular treatment residual contrast enhancement of middle cerebral artery (MCA) on follow up NCCT with clinical and imaging outcomes in patients with acute ischemic stroke.
Methods: We analyzed clinical and radiographic data from all patients with acute MCA occlusion who underwent endovascular treatment at two centers over a 6-year period. The M1 segment of affected MCA was selected with free-hand region of interest on the first post-angiography NCCT; and the average attenuation was determined in Hounsfield units (HU). Bivariate correlation between the MCA contrast enhancement and clinical/imaging outcome was determined.
Results: A total of 89 patients (mean age ± SD, 66.4 ± 15.5 years) with MCA occlusion were included. The median time interval between the first follow up NCCT and the time of catheterization, and the time of recanalization (if successful) were 1.7 h (interquartile range: 1.2 - 2.4), and 0.8 h (interquartile range: 0.5 - 1.6), respectively. MCA contrast enhancement with an average attenuation of >40 HU was seen in 74 of 89 patients. There was no significant correlation between the average attenuation of the affected MCA on post- endovascular treatment NCCT and post- endovascular treatment “Thrombolysis in Cerebral Infarction” (TICI) score (p=0.43), Qureshi score (p=0.61), discharge National Institutes of Health Stroke Scale (NIHSS) score (p=0.34), or 3-month modified Rankin score (p=0.51). However, the MCA contrast enhancement was inversely correlated with time interval between NCCT and catheterization (p<0.001) and angiographic recanalization (p<0.001).
Conclusion: In patients with acute ischemic stroke, the residual contrast enhancement of the affected MCA on NCCT post- endovascular treatment does not correlate with status of recanalization or clinical outcome.
Author Disclosures: S. Payabvash: None. M.H. Qureshi: None. S. Majidi: None. A.I. Qureshi: None.
- © 2014 by American Heart Association, Inc.