Relevance of persistent perfusion deficits on clinical outcomes after successful endovascular treatment : a prospective serial magnetic resonance study
Valls Carbó, Adrián (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Palomar, A. (Canon Medical Systems Spain and Portugal)
Laredo, C. (Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS))
Werner, Mariano (Hospital Clínic i Provincial de Barcelona)
Dorado Bouix, Laura (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Remollo Friedemann, Sebastián (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Munuera, Josep (Institut de Recerca Sant Pau)
Puig, Josep (Hospital Clínic i Provincial de Barcelona)
Silva, Y. (Hospital Universitari de Girona Doctor Josep Trueta)
Pérez de la Ossa, Natalia (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Gomis, Meritxell (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Bustamante, Alejandro (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Castaño, Carlos (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Muñoz, Lucía (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Domenech, Sira (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Terceño, M. (Hospital Universitari de Girona Doctor Josep Trueta)
Millán, Mònica (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Hernández-Pérez, María (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Universitat Autònoma de Barcelona

Date:	2025
Abstract:	Background: Half of the patients who undergo successful recanalization after endovascular treatment (EVT) experience poor clinical outcomes. Impaired microvascular reperfusion (IMR) may explain this lack of improvement, but its frequency and clinical significance remain unclear. The study aims to describe the frequency and associated factors of IMR. Materials and methods: We conducted a study on a cohort of patients with anterior large artery occlusion, treated with EVT at a single center, who achieved mTICI ≥2C. Perfusion MRI was obtained at arrival, up to 2 h after EVT (post-EVT MRI), and on day 5. IMR was observed only on the post-EVT relative cerebral blood volume (rCBV) maps as voxels within the follow-up ischemic lesion, exhibiting a > 15% asymmetry compared to a mirror homolog, in the absence of internal carotid occlusion, hemorrhagic transformation, or arterial reocclusion. Patients with an IMR volume greater than 5 mL were defined as having significant IMR. IMR was analyzed as a binary variable (presence/absence using the 5 mL cut-off) and by total and relative volume. Results: IMR was present in 8 out of 33 patients (24. 2%), with 4 out of 11 (36. 4%) having mTICI 2C, and 4 out of 22 (18. 2%) having mTICI 3. After adjustment for relevant variables, absolute and relative IMR volumes were associated with higher National Institutes of Health Stroke Scale (NIHSS) scores at 5 days (adjusted beta =0. 50 [0. 05, 0. 96], p = 0. 03) and at 24 h (adjusted beta = 0. 11 [0. 02, 0. 19], p = 0. 01). No independent associations were found between IMR and the 90-day modified Rankin Scale (mRS). Conclusion: IMR is present in one-quarter of patients and is associated with worse early neurological outcomes.
Grants:	Instituto de Salud Carlos III PI21/01548
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	MRI ; Ischemic stroke ; No-reflow ; Perfusion imaging ; Reperfusion
Published in:	Frontiers in neurology, Vol. 16 (2025) , p. 1478240, ISSN 1664-2295

DOI: 10.3389/fneur.2025.1478240
PMID: 40083459

8 p, 679.1 KB

The record appears in these collections:
Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut de Recerca Sant Pau
Articles > Research articles
Articles > Published articles