Irene Martin Lores MRCS, Presenter: Nothing to Disclose

Manuel M. Moreu MD, Abstract Co-Author: Nothing to Disclose

Carlos I Gomez-Escalonilla, Abstract Co-Author: Nothing to Disclose

Juan Arrazola, Abstract Co-Author: Nothing to Disclose

Luis Lopez Ibor, Abstract Co-Author: Nothing to Disclose

To study the relationship between the hyperdense middle cerebral artery sign with the clinical outcome at three months and the recanalization rate after an intra-arterial procedure in patients with acute ischemic stroke.

A retrospective cohort study was made with all patients with an anterior ischemic stroke attended in our department during 2008-2013. All of them went through an endovascular procedure. They were divided in two groups using a non-contrast CT, based on the hyperdense vessel sign (defined as an hyperdense vessel diagnosed by two independent observers using a 35/35 window levels and comparing with contralateral vessel). Recanalisation rate was determined with the last image of the intra-arterial procedure by two independent observers and graded using TICI scale. A neurologist based on modified Rankin scale, 90 days after the stroke, defined clinical outcome.  

94 patients were evaluated with a mean age of 64,6 years old, 48 patients (51,1%) where women and 46 (48,9%) men. Median NIHSS was 19. Intra-arterial procedure was made with stent retrievers in almost all of the patients (93,6%). Hyperdense vessel sign was described in 55 patients. Good outcomes where identified in 37 patients and 3 month mortality was17%. Statistic analysis was made using SPSS 20. Bad neurological outcome was more probable with an hyperdense vessel sign at 90 days (p=0,004) and at 7 days(p=0,002). Recanalization was harder in patients with hyperdense vessel sign (p=0,009).  

In patients where mechanical thrombectomy is an option hyperdense vessel sign have worse clinical outcomes and implies lower recanalization rates.

Although the results after the revascularization therapy are worse in patients with hyperdense vessel than in patients without this sign, it is still better than leaving the vessel closed. Therefore we recommend for these patients the use of intraarterial devices with better index results

Martin Lores, I, Moreu, M, Gomez-Escalonilla, C, Arrazola, J, Lopez Ibor, L, Association of Hyperdense Middle Cerebral Artery Sign with Clinical Outcomes and Recanalization Rates in Patients with Acute Ischemic Stroke Treated with Intra-arterial Procedures.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14045675.html