Incidence, Risk Factors, and Clinical Implications of Subarachnoid Hyperdensities on Flat-Panel Detector CT following Mechanical Thrombectomy in Patients with Anterior Circulation Acute Ischemic Stroke

References

1. 1.↵
   1. Powers WJ,
   2. Rabinstein AA,
   3. Ackerson T, et al

   . Guidelines for the Early Management of Patients with Acute Ischemic Stroke: 2019 Update to the 2018 Guidelines for the Early Management of Acute Ischemic Stroke—A Guideline for Healthcare Professionals from the American Heart Association/American Stroke Association. Stroke 2019;50:e344–418 doi:10.1161/STR.0000000000000211 pmid:31662037

   CrossRefPubMed
2. 2.↵
   1. Turc G,
   2. Bhogal P,
   3. Fischer U, et al

   . European Stroke Organisation (ESO). European Society for Minimally Invasive Neurological Therapy (ESMINT) Guidelines on Mechanical Thrombectomy in Acute Ischaemic Stroke Endorsed by Stroke Alliance for Europe (SAFE). Eur Stroke J 2019;4:6–12 doi:10.1177/2396987319832140 pmid:31165090

   CrossRefPubMed
3. 3.↵
   1. Puntonet J,
   2. Richard ME,
   3. Edjlali M

   , et al. Imaging findings after mechanical thrombectomy in acute ischemic stroke. Stroke 2019;50:1618–25 doi:10.1161/STROKEAHA.118.024754 pmid:31060439

   CrossRefPubMed
4. 4.↵
   1. Brehm A,
   2. Tsogkas I,
   3. Ospel JM, et al

   . Direct to angiography suite approaches for the triage of suspected acute stroke patients: a systematic review and meta-analysis. Ther Adv Neurol Disord 2022;15:17562864221078177 doi:10.1177/17562864221078177 pmid:35251309

   CrossRefPubMed
5. 5.↵
   1. DiNitto J,
   2. Feldman M,
   3. Grimaudo H, et al

   . Flat-panel dual-energy head computed tomography in the angiography suite after thrombectomy for acute stroke: a clinical feasibility study. Interv Neuroradiol 2023 Feb 14. [Epub ahead of print] doi:10.1177/15910199231157462 pmid:36788203

   CrossRefPubMed
6. 6.↵
   1. Doerfler A,
   2. Golitz P,
   3. Engelhorn T, et al

   . Flat-panel computed tomography (DYNA-CT) in neuroradiology. from high-resolution imaging of implants to one-stop-shopping for acute stroke. Clin Neuroradiol 2015;25(Suppl 2):291–97 doi:10.1007/s00062-015-0423-x pmid:26091842

   CrossRefPubMed
7. 7.↵
   1. Psychogios MN,
   2. Buhk JH,
   3. Schramm P, et al

   . Feasibility of angiographic CT in peri-interventional diagnostic imaging: a comparative study with multidetector CT. AJNR Am J Neuroradiol 2010;31:1226–31 doi:10.3174/ajnr.A2086 pmid:20360343

   Abstract/FREE Full Text
8. 8.↵
   1. Psychogios MN,
   2. Maier IL,
   3. Tsogkas I, et al

   . One-stop management of 230 consecutive acute stroke patients: report of procedural times and clinical outcome. J Clin Med 2019;8:2185 doi:10.3390/jcm8122185 pmid:31835763

   CrossRefPubMed
9. 9.↵
   1. Whitney E,
   2. Khan YR,
   3. Alastra A, et al

   . Contrast extravasation post thrombectomy in patients with acute cerebral stroke: a review and recommendations for future studies. Cureus 2020;12:e10616 doi:10.7759/cureus.10616 pmid:33123430

   CrossRefPubMed
10. 10.↵
    1. Amans MR,
    2. Cooke DL,
    3. Vella M, et al

    . Contrast staining on CT after DSA in ischemic stroke patients progresses to infarction and rarely hemorrhages. Interv Neuroradiol 2014;20:106–15 doi:10.15274/INR-2014-10016 pmid:24556308

    CrossRefPubMed
11. 11.↵
    1. An H,
    2. Zhao W,
    3. Wang J, et al

    . Contrast staining may be associated with intracerebral hemorrhage but not functional outcome in acute ischemic stroke patients treated with endovascular thrombectomy. Aging Dis 2019;10:784–92 doi:10.14336/AD.2018.0807 pmid:31440384

    CrossRefPubMed
12. 12.↵
    1. Antonucci MU,
    2. Mocco J,
    3. Bennett JA

    . New insight into transient contrast enhancement on computed tomography after endovascular treatment of stroke. Interv Neuroradiol 2012;18:303–08 doi:10.1177/159101991201800309 pmid:22958769

    CrossRefPubMed
13. 13.↵
    1. Cabral FB,
    2. Castro-Afonso LH,
    3. Nakiri GS, et al

    . Hyper-attenuating brain lesions on CT after ischemic stroke and thrombectomy are associated with final brain infarction. Interv Neuroradiol 2017;23:594–600 doi:10.1177/1591019917729550 pmid:28950737

    CrossRefPubMed
14. 14.↵
    1. Jang YM,
    2. Lee DH,
    3. Kim HS, et al

    . The fate of high-density lesions on the non-contrast CT obtained immediately after intra-arterial thrombolysis in ischemic stroke patients. Korean J Radiol 2006;7:221–28 doi:10.3348/kjr.2006.7.4.221 pmid:17143024

    CrossRefPubMedWeb of Science
15. 15.↵
    1. Lee H,
    2. Qureshi AM,
    3. Mueller-Kronast NH, et al

    . Subarachnoid hemorrhage in mechanical thrombectomy for acute ischemic stroke: analysis of the STRATIS Registry—systematic review and meta-analysis. Front Neurol 2021;12:663058 doi:10.3389/fneur.2021.663058 pmid:34113310

    CrossRefPubMed
16. 16.↵
    1. Lummel N,
    2. Schulte-Altedorneburg G,
    3. Bernau C, et al

    . Hyperattenuated intracerebral lesions after mechanical recanalization in acute stroke. AJNR Am J Neuroradiol 2014;35:345–51 doi:10.3174/ajnr.A3656 pmid:23907245

    Abstract/FREE Full Text
17. 17.↵
    1. Lun R,
    2. Walker GB,
    3. Guenego A, et al

    . Is this contrast? Is this blood? An agreement study on post-thrombectomy computed tomography scans. Front Neurol 2020;11:593098 doi:10.3389/fneur.2020.593098 pmid:33414757

    CrossRefPubMed
18. 18.↵
    1. Nakano S,
    2. Iseda T,
    3. Kawano H, et al

    . Parenchymal hyperdensity on computed tomography after intra-arterial reperfusion therapy for acute middle cerebral artery occlusion: incidence and clinical significance. Stroke 2001;32:2042–48 doi:10.1161/hs0901.095602 pmid:11546895

    Abstract/FREE Full Text
19. 19.↵
    1. Nakano S,
    2. Iseda T,
    3. Yoneyama T, et al

    . Early CT signs in patients with acute middle cerebral artery occlusion: incidence of contrast staining and haemorrhagic transformations after intra-arterial reperfusion therapy. Clin Radiol 2006;61:156–62 pmid:16439221

    CrossRefPubMed
20. 20.↵
    1. Parrilla G,
    2. Garcia-Villalba B,
    3. Espinosa de Rueda M, et al

    . Hemorrhage/contrast staining areas after mechanical intra-arterial thrombectomy in acute ischemic stroke: imaging findings and clinical significance. AJNR Am J Neuroradiol 2012;33:1791–96 doi:10.3174/ajnr.A3044 pmid:22538076

    Abstract/FREE Full Text
21. 21.↵
    1. Payabvash S,
    2. Khan AA,
    3. Qureshi MH, et al

    . Detection of intraparenchymal hemorrhage after endovascular therapy in patients with acute ischemic stroke using immediate postprocedural flat-panel computed tomography scan. J Neuroimaging 2016;26:213–18 doi:10.1111/jon.12277 pmid:26282065

    CrossRefPubMed
22. 22.↵
    1. Payabvash S,
    2. Qureshi MH,
    3. Khan SM, et al

    . Differentiating intraparenchymal hemorrhage from contrast extravasation on post-procedural noncontrast CT scan in acute ischemic stroke patients undergoing endovascular treatment. Neuroradiology 2014;56:737–44 doi:10.1007/s00234-014-1381-8 pmid:24925217

    CrossRefPubMed
23. 23.↵
    1. Phan CM,
    2. Yoo AJ,
    3. Hirsch JA, et al

    . Differentiation of hemorrhage from iodinated contrast in different intracranial compartments using dual-energy head CT. AJNR Am J Neuroradiol 2012;33:1088–94 doi:10.3174/ajnr.A2909 pmid:22268092

    Abstract/FREE Full Text
24. 24.↵
    1. Shi ZS,
    2. Liebeskind DS,
    3. Loh Y, et al

    ; UCLA Endovascular Stroke Therapy Investigators. Predictors of subarachnoid hemorrhage in acute ischemic stroke with endovascular therapy. Stroke 2010;41:2775–81 doi:10.1161/STROKEAHA.110.587063 pmid:21051673

    Abstract/FREE Full Text
25. 25.↵
    1. Xu C,
    2. Zhou Y,
    3. Zhang R, et al

    . Metallic hyperdensity sign on noncontrast CT immediately after mechanical thrombectomy predicts parenchymal hemorrhage in patients with acute large-artery occlusion. AJNR Am J Neuroradiol 2019;40:661–67 doi:10.3174/ajnr.A6008 pmid:30846439

    Abstract/FREE Full Text
26. 26.↵
    1. Yedavalli V,
    2. Sammet S

    . Contrast extravasation versus hemorrhage after thrombectomy in patients with acute stroke. J Neuroimaging 2017;27:570–76 doi:10.1111/jon.12446 pmid:28514045

    CrossRefPubMed
27. 27.↵
    1. Yoon W,
    2. Seo JJ,
    3. Kim JK, et al

    . Contrast enhancement and contrast extravasation on computed tomography after intra-arterial thrombolysis in patients with acute ischemic stroke. Stroke 2004;35:876–81 doi:10.1161/01.STR.0000120726.69501.74 pmid:14988575

    Abstract/FREE Full Text
28. 28.↵
    1. You SH,
    2. Kim B,
    3. Kim BK, et al

    . MR imaging for differentiating contrast staining from hemorrhagic transformation after endovascular thrombectomy in acute ischemic stroke: phantom and patient study. AJNR Am J Neuroradiol 2018;39:2313–19 doi:10.3174/ajnr.A5848 pmid:30385471

    Abstract/FREE Full Text
29. 29.↵
    1. Zidan M,
    2. Ghaei S,
    3. Bode FJ, et al

    . Clinical significance and prevalence of subarachnoid hyperdensities on flat detector CT after mechanical thrombectomy: does it really matter? J Neurointerv Surg 2023 Aug 30 [Epub ahead of print] doi:10.1136/jnis-2023-020661 pmid:37648432

    Abstract/FREE Full Text
30. 30.↵
    1. Mujanovic A,
    2. Windecker D,
    3. Serrallach BL, et al

    . Connecting the DOTs: a novel imaging sign on flat-panel detector CT indicating distal vessel occlusions after thrombectomy. J Neurointerv Surg 2024 Jan 19 [Epub ahead of print] doi:10.1136/jnis-2023-021218 pmid:38253377

    Abstract/FREE Full Text
31. 31.↵
    1. Saver JL,
    2. Chapot R,
    3. Agid R, et al

    ; Distal Thrombectomy Summit Group. Thrombectomy for distal, medium vessel occlusions: a consensus statement on present knowledge and promising directions. Stroke 2020;51:28722–84 doi:10.1161/STROKEAHA.120.028956 pmid:32757757

    CrossRefPubMed
32. 32.↵
    1. Liebeskind DS,
    2. Bracard S,
    3. Guillemin F, et al

    . eTICI reperfusion: defining success in endovascular stroke therapy. J Neurointerv Surg 2019;11:4332–38 doi:10.1136/neurintsurg-2018-014127 pmid:30194109

    CrossRefPubMed
33. 33.↵
    1. Petroulia VD,
    2. Kaesmacher J,
    3. Piechowiak EI, et al

    . Evaluation of Sine Spin flat detector CT imaging compared with multidetector CT. J Neurointerv Surg 2023;15:292–97 doi:10.1136/neurintsurg-2021-018312 pmid:35318960

    Abstract/FREE Full Text
34. 34.↵
    1. Fischer U,
    2. Kaesmacher J,
    3. Strbian D, et al

    . Thrombectomy alone versus intravenous alteplase plus thrombectomy in patients with stroke: an open-label, blinded-outcome, randomised non-inferiority trial. Lancet 2022;400:104–15 doi:10.1016/S0140-6736(22)00537-2 pmid:35810756

    CrossRefPubMed
35. 35.↵
    1. Venema E,
    2. Roozenbeek B,
    3. Mulder M, et al

    ; HERMES Collaborators and MR CLEAN Registry Investigators. Prediction of outcome and endovascular treatment benefit: validation and update of the MR PREDICTS Decision Tool. Stroke 2021;52:2764–72 doi:10.1161/STROKEAHA.120.032935 pmid:34266308

    CrossRefPubMed
36. 36.↵
    R Core Team. R: A Language and Environment for Statistical Computing. Vienna, Austria: R Foundation for Statistical Computing; 2021
37. 37.↵
    1. Kaesmacher J,
    2. Bellwald S,
    3. Dobrocky T, et al

    . Safety and efficacy of intra-arterial urokinase after failed, unsuccessful, or incomplete mechanical thrombectomy in anterior circulation large-vessel occlusion stroke. JAMA Neurol 2020;77:318–26 doi:10.1001/jamaneurol.2019.4192 pmid:31816018

    CrossRefPubMed
38. 38.↵
    1. Kaesmacher J,
    2. Ospel JM,
    3. Meinel TR, et al

    . Thrombolysis in cerebral infarction 2b reperfusions: to treat or to stop? Stroke 2020;51:3461–71 doi:10.1161/STROKEAHA.120.030157 pmid:32993461

    CrossRefPubMed
39. 39.↵
    1. Renu A,
    2. Millan M,
    3. San RL, et al

    . CHOICE Investigators. Effect of intra-arterial alteplase vs placebo following successful thrombectomy on functional outcomes in patients with large vessel occlusion acute ischemic stroke: the CHOICE Randomized Clinical Trial. JAMA 2022;327:826–35 doi:10.1001/jama.2022.1645 pmid:35143603

    CrossRefPubMed
40. 40.↵
    1. Chung Y,
    2. Bae Y,
    3. Hong CE, et al

    . Hyperattenuations on flat-panel computed tomography after successful recanalization of mechanical thrombectomy for anterior circulation occlusion. Quant Imaging Med Surg 2022;12:1051–62 doi:10.21037/qims-21-322 pmid:35111604

    CrossRefPubMed
41. 41.↵
    1. Baek JH,
    2. Kim BM,
    3. Heo JH, et al

    . Association between flat-panel computed tomography hyperattenuation and clinical outcome after successful recanalization by endovascular treatment. J Neurosurg 2020;135:704–11 doi:10.3171/2020.7.JNS193214 pmid:33361477

    CrossRefPubMed
42. 42.↵
    1. Riederer I,
    2. Si-Mohamed S,
    3. Ehn S, et al

    . Differentiation between blood and iodine in a bovine brain-Initial experience with Spectral Photon-Counting Computed Tomography (SPCCT). PLoS One 2019;14:e0212679 doi:10.1371/journal.pone.0212679 pmid:30802258

    CrossRefPubMed
43. 43.↵
    1. Teng D,
    2. Pannell JS,
    3. Rennert RC, et al

    . Endothelial trauma from mechanical thrombectomy in acute stroke: in vitro live-cell platform with animal validation. Stroke 2015;46:1099–106 doi:10.1161/STROKEAHA.114.007494 pmid:25712942

    Abstract/FREE Full Text
44. 44.↵
    1. Khatri R,
    2. Khatri P,
    3. Khoury J, et al

    . Microcatheter contrast injections during intra-arterial thrombolysis increase intracranial hemorrhage risk. J Neurointerv Surg 2010;2:115–19 doi:10.1136/jnis.2009.000794 pmid:21990590

    Abstract/FREE Full Text