Hyperdense middle cerebral artery sign predicts favorable outcome in patients undergoing mechanical thrombectomy

AbstractNon-contrast computer tomography detects the presence of hyperdense middle cerebral artery sign (HMCAS). Studies on the prognostic value of HMCAS among patients undergoing mechanical thrombectomy (MT) are conflicting. A retrospective analysis of consecutive patients with acute ischemic stroke due to middle cerebral artery occlusion, presenting with or without HMCAS, who underwent MT, was performed. We enrolled 191 patients (HMCAS +, n  = 140; HMCAS –, n = 51). Prevalence of successful recanalization was significantly higher in patients with HMCAS than in those without HMCAS (92.1% versus 74.5%, p = 0.001). Patients with HMCAS had a better clinical outcome than those HMCAS – (54.3% versus 37.3%, p = 0.037, for three-month favorable outcome; 62.9% versus 39.3%, p = 0.004, for major neurological improvement at discharge; 8.6% versus 19.6%, p = 0.035, for in-hospital mortality; 14.3% versus 27.5%, p = 0.035, for intracranial hemorrhage; 2.9% versus 17.6%, p = 0.001, for symptomatic intracrani al hemorrhage). Multivariate analyses confirmed that HMCAS represents an independent predictor of three-month favorable outcome (OR 2.48, 95% CI 1.10–5.58, p = 0.028), major neurological improvement at discharge (OR 2.40, 95% CI 1.09–5.20, p = 0.030), in-hospital mortality (OR 0.29, 95% CI 0.010–0.81, p = 0.018), presence of ICH (OR 0.49, 95% CI 0.25–0.97, p = 0.042) and presence of SICH (OR 0.16, 95% CI 0.04–0.63, p =â€...
Source: Journal of Thrombosis and Thrombolysis - Category: Hematology Source Type: research