Ultrasonography Evaluation After Endovascular Recanalization Therapy : Usevert Study

• Main Authors: Jiménez, Marīa Romeral, Gómez-Escalonilla , C. Escobar
• Format: Web Resource
• Language: English
• Published: Morressier 01.01.2017
• DOI: 10.26226/morressier.5cb58cf6c668520010b56651

Cerebral hyperperfusion has been associated with an unfavourable outcome after endovascular recanalization therapy, secondary to a failure in the cerebral vascular self-regulation.To analyse the frequency and associated factors after endovascular revascularization in large vessel occlusion ischaemic stroke and its prognostic association.Prospective study of patients with acute ischaemic stroke due to occlusion of the terminal internal carotid artery or middle cerebral artery (MCA), treated with mechanical thrombectomy and TICI2B-3 recanalization. There was no concomitant stenosis in the cervical carotid artery or contralateral carotid artery. A neurosonological study of both MCAs was performed at 6, 24 and 48 hours after the endovascular procedure. Mean velocities (MV) and percentage variability after recanalization and their association with infarct size, symptomatic intracranial haemorrhage (sICH) and clinical outcome were analysed. 91 patients with a median age of 78 years (IQR 62 - 84) and NIHSS 18 (IQR 12-22). In 77% the occlusion was at the MCA and intravenous thrombolysis was used in 40.7%. The incidence of sICH was 5.5%. At three months, the mortality rate was 19.8% and functional independence (mRSu22642) 52.7%. There was a significant association between the increase in MV in the treated MCA (in comparison to the contralateral MCA) with the infarct size, mortality and functional dependence at three months. In multivariate analysis, an increase >50% had a poor clinical outcome OR of 6.83. All patients with an increase >80% presented poor clinical outcome.The increase of MV in the first 24 hours after endovascular recanalization has a significant prognostic relevance.