title: Middle Cerebral Artery Residual Contrast Stagnation on Noncontrast CT Scan Following Endovascular Treatment in Acute Ischemic Stroke Patients.
abstract: OBJECTIVE
  We evaluated the relationship between middle cerebral artery (MCA) residual contrast stagnation on immediate postprocedural noncontrast CT scan and intraparenchymal hemorrhage (IPH) after endovascular treatment in acute ischemic stroke patients.
  
  
  METHODS
  The clinical and imaging data from patients with acute unilateral MCA M1 occlusion who underwent endovascular treatment over a 3.5-year period were reviewed. Bilateral M1 segments were selected on the first postangiography CT scan, and average attenuation was determined in Hounsfield units (HU); the difference between average HU values was calculated. Postprocedural CT scans were also evaluated for presence of IPH, defined as hyperdensity persisting on follow-up CT scans obtained >24-hours postprocedure.
  
  
  RESULTS
  Of 80 patients included in our series; 10/80 developed IPH on immediate postprocedural CT scan. Patients with IPH had a higher (ipsilateral-contralateral) M1 residual attenuation difference (P < .001). An average ipsilateral M1 attenuation which was ≥5 HU greater than contralateral artery had a 3.8 times increase in relative risk of IPH (95% confidence interval: 2-7.1).
  
  
  CONCLUSIONS
  On immediate postprocedural noncontrast CT scan of stroke patients with acute MCA M1 occlusion after endovascular treatment, higher residual contrast stagnation in the affected MCA, compared to contralateral artery, is associated with an increased risk of IPH.
authors: Zeenat Qureshi Stroke Institute, St. Cloud, MN.
authors: Seyedmehdi
authors: S
authors: Payabvash
authors: Zeenat Qureshi Stroke Institute, St. Cloud, MN.
authors: Mushtaq H
authors: MH
authors: Qureshi
authors: Department of Radiology, University of Minnesota, Minneapolis, MN.
authors: Shayandokht
authors: S
authors: Taleb
authors: Zeenat Qureshi Stroke Institute, St. Cloud, MN.|Department of Radiology, University of Minnesota, Minneapolis, MN.
authors: Swaroop
authors: S
authors: Pawar
authors: Zeenat Qureshi Stroke Institute, St. Cloud, MN.
authors: Adnan I
authors: AI
authors: Qureshi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000000981:diagnostic imaging* / Q000628:therapy; D002533:Cerebral Angiography / Q000379:methods; D003287:Contrast Media; D057510:Endovascular Procedures / Q000379:methods*; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging*; D012720:Severity of Illness Index; D020521:Stroke / Q000000981:diagnostic imaging* / Q000628:therapy; D017131:Thrombectomy / Q000379:methods*; D015912:Thrombolytic Therapy / Q000379:methods*; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed / Q000379:methods
chemical_list: D003287:Contrast Media; D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator
keywords: Middle cerebral artery; contrast stagnation; intra-arterial treatment; intraparenchymal hemorrhage; ischemic stroke; noncontrast CT