Abstract Details

Title Prevalence and Effect of 'No Reflow' Phenomenon Following Endovascular Treatment Related Recanalization in Patients with Acute Middle Cerebral Artery Occlusion

Topic Interventional Neurology

Presentation(s) P07 - (-)

Poster/Presentation
Number 264

Objective

Background BACKGROUND: In acute arterial occlusion, 'no reflow' phenomenon is the angiographic finding of delayed washout of contrast from arterial bed despite recanalization of occluded artery.

Design/Methods DESIGN/METHODS: We reviewed charts and angiograms of all patients presented to our institution with acute middle cerebral artery (MCA) occlusion related ischemic stroke in the past 5 years, treated with endovascular treatment.Patients with successful recanalization and intact ipsilateral anterior cerebral artery (ACA) were included. The dynamic images from the final post-recanalization angiographic images were used to determine whether there was any regional delay in washout of contrast material from the MCA arterial bed compared with ACA arterial bed. All images were reviewed by two independent reviewers and any discrepancy was resolved by a third adjudicator.

Results RESULTS: A total of 74 patients were identified, of which 53 (mean age ± standard deviation [±SD] 65±17; 26 were men) met the study criteria. Delayed contrast washout in the distribution of MCA artery post-recanalization was observed in 44 (83%) patients of 53 patients. When sample was dichotomized according to presence or absence of delay, there were no differences in demographics, baseline medical co morbidities, presenting stroke severity (admission [NIHSS] score), time to endovascular procedure, or being treated with pharmacological versus mechanical thrombolysis, between the two groups. Rates of favorable outcome (mRS 0-2) at discharge (50% versus 44%, p=1.0) and early neurological improvement (NIHSS score improvement by ?4 points within 24 hours) (67% versus 56%, p=0.7) was similar between the two groups.

Conclusions CONCLUSIONS: No reflow phenomenon is very common after recanalization of MCA in the setting of acute ischemic stroke. However, in our sample, we did not observe any relationship between no reflow phenomenon and clinical outcomes suggesting that this phenomenon may be a transient occurrence.

Authors/Disclosures
PRESENTER	No disclosure on file
Ameer Hassan, DO (Valley Baptist Medical Center)	Dr. Hassan has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Medtronic. Dr. Hassan has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Stryker. Dr. Hassan has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Penumbra. Dr. Hassan has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Cerenovus. Dr. Hassan has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Viz.ai. Dr. Hassan has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Genentech. Dr. Hassan has received research support from GE Healthcare.
Basit Rahim, MD (Virginia Commonwealth University Health System)	No disclosure on file
	No disclosure on file
Hamza I. Maqsood, MD (Dept of Neurology)	Dr. Qureshi has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for AstraZeneca.

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