Susceptibility vessel sign as a predictor for recanalization and clinical outcome in acute ischaemic stroke: A systematic review and meta-analysis

• Published in: Journal of clinical neuroscience Vol. 94; pp. 159 - 165
• Main Authors: Tang, Si Zhao, Sen, Jon, Goh, Yong Geng, Anil, Gopinathan
• Format: Journal Article
• Language: English
• Published: Elsevier Ltd 01.12.2021
• Subjects: Mechanical Thrombectomy; MRI; Outcome; Prognosis; Stroke; Susceptibility Vessel Sign; Mechanical Thrombectomy; Stroke; Prognosis; MRI; Outcome; Susceptibility Vessel Sign
• ISSN: 0967-5868; 1532-2653
• DOI: 10.1016/j.jocn.2021.10.017

•SVS is associated with good clinical outcome after mechanical thrombectomy for stroke.•Mechanical thrombectomy shows better recanalization rate in stroke patients with SVS.•Clot content can be assessed using SVS to determine reperfusion strategy and prognosis. To assess the prognostic values of susceptibility vessel sign (SVS) on T2*-weighted MRI using GRE and SWI sequences for recanalization status and clinical outcomes in patients with acute ischaemic stroke undergoing different therapies. Literature search on PubMed, EMBASE databases and other sources from inception up to 01 June 2021 was conducted. 11 studies which reported SVS, recanalization and clinical outcomes were included in qualitative synthesis and meta-analysis. Pooled analysis demonstrated significant association between good clinical outcome and SVS-positive patients who underwent mechanical thrombectomy (RR = 1.34, 95% CI = 1.07–1.67, p = 0.01), which is in line with higher recanalization rate in SVS-positive patients who were treated with mechanical thrombectomy compared to intravenous thrombolysis only. No statistically significant association was demonstrated between presence of SVS and successful recanalization, likely due to limitations in the recruited studies. Presence of SVS in patients with acute ischaemic stroke who underwent mechanical thrombectomy is associated with good clinical outcome. SVS-positive patients treated with mechanical thrombectomy also shows better recanalization rate comparing to intravenous thrombolysis only, although not statistically significant. MRI assessment of the clot content using SVS is useful in selection of reperfusion strategy for acute ischaemic stroke and prognostication.