Abstract WP26: Factors Related to Acute Brain Swelling After Successful Recanalization With Mechanical Thrombectomy

• Published in: Stroke (1970) 2019-02, Vol.50 (Suppl_1)
• Main Authors: Hamada, Yuki, Tatsuno, Kentaro, Takayuki, Fukano, Tokuyama, Yoshiaki, Takaishi, Satoshi, Usuki, Noriko, Takada, Tatsuro, Yoshida, Yasuyuki, Ono, Hajime, Ueda, Toshihiro
• Format: Article
• Language: English
• ISSN: 0039-2499; 1524-4628
• DOI: 10.1161/str.50.suppl_1.WP26

Abstract only Background and Purpose: We have experienced acute ischemic stroke patients who had poor outcome due to acute brain swelling after successful recanalization with mechanical thrombectomy. The aim of this study was to investigate factors related to acute brain swelling. Methods: The study included 89 patients who obtained successful recanalization (TICI 2b or 3) after mechanical thrombectomy for occlusions of the internal carotid artery (ICA) or middle cerebral artery from 2013 to June 2016. We classified by the distance of midline shift on FLAIR image including the lens nucleus and thalamus within 24 hours after treatment into 2 groups; more than 5 mm (Swelling group; the S group, n=16), and less than 5 mm (Non-Swelling; the N group, n=73). We compared demographic data, radiological characteristics, and outcomes between both groups. We also measured flow transit time (FTT) from intracranial artery to cortical vein with the use of automated software (syngo iflow, Siemens Healthcare, Germany). Results: Regarding mean time of onset-to-reperfusion time, medical history, treatment with IV-rtPA, there were no significant differences between both groups. Increase rate of the brain swelling area before and after treatment on FLAIR image was higher in the S group (20.9%) than in the N group (3.0%). The median FTT of the S group was 7.0 sec (IQR 4.5-7.5), the N group was 6.0 sec (5.2-6.5). The S group included more patients of ICA occlusion (80% vs. 46%, p=0.023), longer FTT (>7.0 sec, 60% vs. 13%, p