Abstract
Objectives
The aim of the study is to analyze the hemodynamic changes in the middle cerebral
artery (MCA) after endovascular revascularization in acute ischemic stroke (AIS) due
to large vessel occlusion and its association with the infarct volume size in the
control head CT.
Materials and Methods
Prospective study of patients with AIS due to internal carotid artery terminus or
M1 segment of the MCA occlusion, who underwent endovascular treatment with a final
TICI 2b-3 score, without concomitant stenosis ≥50% in both cervical carotid arteries.
Transcranial Doppler ultrasound (TCD) of both MCAs was carried out at 6 h after the
endovascular procedure. Mean flow velocities (MFV) after arterial reperfusion and
its association with the infarct volume size in 24−36 h control head CT were determined.
Results
91 patients (51 women) were included with a median age of 78 years and National institute
of Health Stroke Scale of 18. The MCA was occluded in 76.92%, and intravenous thrombolysis
was administered in 40.7%. The incidence of symptomatic intracranial hemorrhage was
5.5%. At three months, mortality was 19.8% and a 52.7% of patients achieved functional
independence (modified Rankin Scale 0-2). After a multivariable logistic regression
analysis, an increase in the MFV greater than 50% at 6 h in the treated MCA compared
to contralateral MCA, was an independent predictor of large infarct volume in the
control head CT with an OR 9.615 (95%CI: 1.908−47.620), p=0.006
Conclusions
Increased MFV assessed by TCD examination following endovascular recanalization is independently
associated with larger infarct volume
Key Words
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Article info
Publication history
Published online: October 21, 2021
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2021.106149
Copyright
© 2021 Elsevier Inc. All rights reserved.
