title: Arteriovenous shunts and capillary blush as an early sign of basal ganglia infarction after successful mechanical intra-arterial thrombectomy in ischaemic stroke.
abstract: OBJECTIVE
  Recent studies indicate an interest in early infarct assessment, mainly using post-interventional perfusion imaging. This work evaluated two specific angiographic signs for infarct prediction in the basal ganglia immediately after successful mechanical intra-arterial thrombectomy.
  
  
  METHODS
  In this retrospective study, 57 consecutive patients (mean ± SD age 67 ± 15 years) with acute occlusion of the proximal anterior circulation who underwent mechanical thrombectomy of the M1 segment of the middle cerebral artery were included. Two separate angiographic signs, early venous drainage and capillary blush, were identified and analysed regarding their statistical significance for infarct prediction within the basal ganglia.
  
  
  RESULTS
  Four patients were excluded due to parenchymal haemorrhage. Forty-four of 53 patients developed infarction of the basal ganglia. Sensitivity/specificity were 93%/27%, respectively, for the capillary blush sign and 88%/63%, respectively, for the early venous drainage sign. Combining both signs increased the sensitivity and specificity to 88% and 81%, respectively, and increased the positive predictive value to 95%.
  
  
  CONCLUSIONS
  Both angiographic signs seem to predict the irreversible damage of tissue in the basal ganglia reliably despite successful recanalization of the middle cerebral artery in patients with ischaemic stroke.
  
  
  CONCLUSIONS
  • Evaluation of success in neurointerventional procedures is mainly based on recanalization rates. • Two separate angiographic signs can predict infarction immediately after proximal MCA recanalization. • Combining both signs increases their specificity.
authors.affiliation: Department of Neuroradiology, University of Leipzig, Liebigstrasse 20, 04103, Leipzig, Germany.
authors.forename: D
authors.initials: D
authors.lastname: Fritzsch
authors.forename: M
authors.initials: M
authors.lastname: Reiss-Zimmermann
authors.forename: D
authors.initials: D
authors.lastname: Lobsien
authors.forename: U
authors.initials: U
authors.lastname: Quäschling
authors.forename: K T
authors.initials: KT
authors.lastname: Hoffmann
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001164:Arteriovenous Fistula / Q000209:etiology*; D001479:Basal Ganglia / Q000098:blood supply*; D002544:Cerebral Infarction / Q000209:etiology*; D005260:Female; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D020521:Stroke / Q000601:surgery*; D017131:Thrombectomy / Q000379:methods*; D055815:Young Adult