Absent hyperdense middle cerebral artery sign is associated with poor functional outcome after mechanical thrombectomy.

Authors

• Kiddy L Ume
• Sudeepta Dandapat
• Matthew W Weber
• Cynthia B Zevallos
• Amber Fifer
• Abigail Levy
• Kristin Delfino
• Santiago Ortega-Gutierrez
• Fazeel M Siddiqui

Publication/Presentation Date

1-1-2022

Abstract

BACKGROUND: The hyperdense middle cerebral artery sign on computed tomography indicates proximal middle cerebral artery occlusion. Recent reports suggest an association between the hyperdense sign and successful reperfusion. The prognostic value of the hyperdense middle cerebral artery sign in patients receiving mechanical thrombectomy has not been extensively studied.

AIMS: Our study aims to evaluate the association between the hyperdense middle cerebral artery sign and functional outcome in patients with M1 occlusions that had undergone mechanical thrombectomy.

METHODS: We conducted a single-center retrospective observational cohort study of 102 consecutive patients presenting with acute M1 occlusions that had undergone mechanical thrombectomy. Patients were stratified into cohorts based on the presence of hyperdense middle cerebral artery sign visually assessed on computed tomography by two readers. The outcomes of interests were functional disability measured by the ordinal Modified Rankin Scale (mRS) at 90 days, mortality, reperfusion status and hemorrhagic conversion.

RESULTS: Out of the 102 patients with M1 occlusions, 71 had hyperdense middle cerebral artery sign. There was no significant difference between the cohorts in age, baseline mRS, NIHSS, ASPECTS, and time to reperfusion. The absence of hyperdense middle cerebral artery sign was associated with increased odds of being dependent or dying (higher mRS) (OR: 3.24, 95% CI: 1.30-8.06,

CONCLUSION: The absence of hyperdense middle cerebral artery sign is associated with worse functional outcome in patients presenting with M1 occlusions undergoing thrombectomy.

Volume

17

Issue

1

First Page

101

Last Page

108

ISSN

1747-4949

Published In/Presented At

Ume, K. L., Dandapat, S., Weber, M. W., Zevallos, C. B., Fifer, A., Levy, A., Delfino, K., Ortega-Gutierrez, S., & Siddiqui, F. M. (2022). Absent hyperdense middle cerebral artery sign is associated with poor functional outcome after mechanical thrombectomy. International journal of stroke : official journal of the International Stroke Society, 17(1), 101–108. https://doi.org/10.1177/1747493021991972

Disciplines

Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods

PubMedID

33557722

Department(s)

Administration and Leadership

Document Type

Article