title: Decreased hyperintense vessels on FLAIR images after endovascular recanalization of symptomatic internal carotid artery occlusion.
abstract: OBJECTIVE
  Hyperintense vessels (HV) on fluid-attenuated inversion recovery (FLAIR) images were assumed to be explained by slow antegrade or retrograde leptomeningeal collateral flow related to extracranial or intracranial artery steno-occlusion. The aim of this study was to investigate the effect of recanalization after endovascular therapy of symptomatic internal carotid artery (ICA) occlusion on the presence of HV.
  
  
  METHODS
  Eleven patients with symptomatic ICA occlusion were retrospectively enrolled. Changes in the HV on FLAIR images were examined in affected hemisphere of each patient after successful treatment with endovascular recanalization (angioplasty, n = 3; stent-assisted angioplasty, n = 8). The relationship between postoperative changes in the HV and Thrombolysis In Cerebral Ischemia (TICI) scale (I-III) was assessed.
  
  
  RESULTS
  After operation, HV of the 11 affected hemispheres were showed to be decreased (n = 3) or disappeared (n = 8) in treated side. The median interval between pre- and postoperative MRI examinations was 97.0 h (range, from 69. to 48.7h). Of the 8 patients with disappeared HV, 7 achieved high TICI grade flow (III) and 1 had relatively low TICI grade flow (IIc) in treated side. However, all the 3 patients with decreased HV were found to be relatively low TICI grade flow (IIc).
  
  
  CONCLUSIONS
  Our data indicate that endovascular recanalization of ICA occlusion was effective for decreasing HV. Postoperative decrease in HV can be considered as a marker for hemodynamic improvement.
authors.affiliation: Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, 305# East Zhongshan Road, 210002 Nanjing, Jiansu, China.
authors.forename: Wenhua
authors.initials: W
authors.lastname: Liu
authors.forename: Qin
authors.initials: Q
authors.lastname: Yin
authors.forename: Lingling
authors.initials: L
authors.lastname: Yao
authors.forename: Shuanggen
authors.initials: S
authors.lastname: Zhu
authors.forename: Gelin
authors.initials: G
authors.lastname: Xu
authors.forename: Renliang
authors.initials: R
authors.lastname: Zhang
authors.forename: Kaifu
authors.initials: K
authors.lastname: Ke
authors.forename: Xinfeng
authors.initials: X
authors.lastname: Liu
mesh_terms: D000328:Adult; D000368:Aged; D017130:Angioplasty / Q000379:methods*; D002343:Carotid Artery, Internal; D016893:Carotid Stenosis / Q000601:surgery*; D003097:Collateral Circulation; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D015607:Stents; D016896:Treatment Outcome