Artery diameter ratio after recanalization in endovascular therapy for acute ischemic stroke: a new predictor of clinical outcomes.

Abstract

PURPOSE:

This study aimed to investigate the relationship between the artery diameter ratio (ADR) after recanalization and clinical outcomes.

METHODS:

Patients with middle cerebral artery occlusion confirmed by DSA from 1 January 2018, to 31 December 2019, were retrospectively analyzed. All patients confirmed TICI grade 2b or 3. The ADR was calculated as M2 segment diameter/M1 segment diameter. Multivariate regression analysis was used to describe clinical outcomes of two groups (ADR < 0.6 and ≥ 0.6). ROC curves were used to compare different models and find the best cutoff.

RESULTS:

A total of 143 patients were included in the study, including 77 males and 66 females, with an average age of 67.79 ± 12 years. The NIHSS at discharge was significantly higher in the ADR < 0.6 group than another group (mean, 16.37 vs. 6.19, P < 0.001). At 90 days, the cases of functional independence was significantly less in the ADR < 0.6 group (20.97% vs. 83.95%, OR 0.05, 95% CI 0.02-0.12, P < 0.001). The ADR < 0.6 group had a higher incidence of cerebral edema (P = 0.027) and sICH (P = 0.038). The ADR had the strongest power to distinguish mRS > 2 (AUC = 0.851) and DC (AUC = 0.805), and the best cutoff value are 0.6 (specificity 85.19%, sensitivity 75.81%) and 0.58 (specificity 65.96%, sensitivity 100%), respectively.

CONCLUSION:

The low ADR is associated with poor outcomes. The decrease in ADR may be an indirect manifestation of the loss of cerebrovascular autoregulation.

• Authors: Shuhan Huang, Chengchun Liu, Xiaoshu Li, Ya Wu, Chunrong Liang, Wei Li, Meng Zhang
• Journal: Neuroradiology (Neuroradiology) Vol. 64 Issue 4 Pg. 785-793 (Apr 2022) ISSN: 1432-1920 [Electronic] Germany
• PMID: 34708259 (Publication Type: Journal Article)
• Copyright: © 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

Topics

• Aged
• Arteries
• Endovascular Procedures
• Female
• Humans
• Infarction, Middle Cerebral Artery (diagnostic imaging, therapy)
• Ischemic Stroke
• Male
• Middle Aged
• Retrospective Studies
• Stroke (diagnostic imaging, surgery)
• Treatment Outcome