SWI Susceptibility Vessel Sign in Patients Undergoing Mechanical Thrombectomy for Acute Ischemic Stroke.

Belachew, N. F.; Dobrocky, T.; Aleman, E B; Meinel, T. R.; Hakim, A.; Vynckier, J.; Arnold, M.; Seiffge, D. J.; Wiest, R.; Mordasini, P.; Gralla, J.; Fischer, U.; Piechowiak, E. I.; Kaesmacher, J. (2021). SWI Susceptibility Vessel Sign in Patients Undergoing Mechanical Thrombectomy for Acute Ischemic Stroke. AJNR. American journal of neuroradiology, 42(11), pp. 1949-1955. American Society of Neuroradiology 10.3174/ajnr.A7281

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BACKGROUND AND PURPOSE

The frequency and clinical significance of the susceptibility vessel sign in patients with acute ischemic stroke remains unclear. We aimed to assess its prevalence in patients with acute ischemic stroke undergoing mechanical thrombectomy and to analyze its association with interventional and clinical outcome parameters in that group.

MATERIALS AND METHODS

Six hundred seventy-six patients with acute ischemic stroke and admission MR imaging were reviewed retrospectively. Of those, 577 met the eligibility criteria for further analysis. Imaging was performed using a 1.5T or 3T MR imaging scanner. Associations between baseline variables, interventional and clinical outcome parameters, and susceptibility vessel sign were determined with multivariable logistic regression models. Results are shown as adjusted ORs with 95% CIs.

RESULTS

The susceptibility vessel sign was present in 87.5% (n = 505) of patients and associated with tandem occlusion (adjusted OR, 3.3; 95% CI, 1.1-10.0; P = .032) as well as successful reperfusion, defined as an expanded TICI score of ≥2b (adjusted OR, 2.4; 95% CI, 1.28-4.6; P = .007). The susceptibility vessel sign was independently associated with functional independence (mRS ≤ 2: adjusted OR, 2.1; 95% CI, 1.1-4.0; P = .028) and lower mortality (adjusted OR, 0.4; 95% CI, 0.2-0.7; P = .003) at 90 days, even after adjusting for successful reperfusion. The susceptibility vessel sign did not influence the number of passes performed during mechanical thrombectomy, the first-pass reperfusion, or the risk of peri- or postinterventional complications.

CONCLUSIONS

The susceptibility vessel sign is an MR imaging phenomenon frequently observed in patients with acute ischemic stroke and is associated with successful reperfusion after mechanical thrombectomy. However, superior clinical functional outcome and lower mortality noted in patients showing the susceptibility vessel sign could not be entirely attributed to higher reperfusion rates.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic, Interventional and Paediatric Radiology
04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic and Interventional Neuroradiology
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology

UniBE Contributor:

Belachew, Nebiyat Filate; Dobrocky, Tomas; Meinel, Thomas Raphael; Hakim, Arsany; Vynckier, Jan Luc; Arnold, Marcel; Seiffge, David Julian; Wiest, Roland; Mordasini, Pasquale; Gralla, Jan; Fischer, Urs; Piechowiak, Eike Immo and Kaesmacher, Johannes

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1936-959X

Publisher:

American Society of Neuroradiology

Language:

English

Submitter:

Maria de Fatima Henriques Bernardo

Date Deposited:

05 Nov 2021 08:39

Last Modified:

14 Nov 2021 00:14

Publisher DOI:

10.3174/ajnr.A7281

PubMed ID:

34593377

BORIS DOI:

10.48350/160050

URI:

https://boris.unibe.ch/id/eprint/160050

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