Impact of width of susceptibility vessel sign on recanalization following endovascular therapy

• Published in: Journal of the neurological sciences 2023-03, Vol.446, p.120583-120583, Article 120583
• Main Authors: Kanamoto, Tadashi, Tateishi, Yohei, Yamashita, Kairi, Furuta, Kanako, Torimura, Daishi, Tomita, Yuki, Hirayama, Takuro, Shima, Tomoaki, Nagaoka, Atsushi, Yoshimura, Shunsuke, Miyazaki, Teiichiro, Ideguchi, Reiko, Morikawa, Minoru, Morofuji, Yoichi, Horie, Nobutaka, Izumo, Tsuyoshi, Tsujino, Akira
• Format: Article
• Language: English
• Subjects: Brain Ischemia - therapy; Cerebral Infarction; Endovascular Procedures; Endovascular therapy; Humans; Magnetic Resonance Imaging - methods; Retrospective Studies; Stroke - therapy; Susceptibility vessel sign; Susceptibility-weighted imaging; Treatment Outcome
• ISSN: 0022-510X; 1878-5883
• DOI: 10.1016/j.jns.2023.120583

We aimed to investigate the relationship between arterial recanalization following endovascular therapy and the susceptibility vessel sign (SVS) length and width on susceptibility-weighted imaging. We retrospectively evaluated consecutive patients with anterior circulation ischemic stroke who underwent magnetic resonance imaging preceded endovascular therapy, and measured the SVS length and width. Successful recanalization was defined as expanded thrombolysis in cerebral infarction grade of 2b to 3. Logistic regression analysis was executed to determine the independent predictors of successful recanalization and first-pass reperfusion (FPR) after endovascular therapy. Among 100 patients, successful recanalization and FPR were observed in 77 and 34 patients, respectively. The median SVS length and width were 10.3 mm (interquartile range, 6.8–14.1 mm) and 4.2 mm (interquartile range, 3.1–5.2 mm), respectively. In multivariate logistic regression analysis, SVS width was associated with successful recanalization (odds ratio, 1.88; 95% confidence interval, 1.14–3.07; p = 0.005) and FPR (odds ratio, 1.38; 95% confidence interval, 1.01–1.89; p = 0.039). The optimal cutoff value for the SVS width to predict successful recanalization and FPR were 4.2 mm and 4.0 mm, respectively. Larger SVS width may predict successful recanalization and FPR following endovascular therapy. •Larger SVS width predicted good recanalization following endovascular thrombectomy.•The cut-off value of the SVS width to predict successful recanalization was 4.2 mm.•Patients with larger SVS width were more likely to achieved first-pass reperfusion.