White matter burden does not influence the outcome of mechanical thrombectomy

• Published in: Journal of neurology Vol. 267; no. 3; pp. 618 - 624
• Main Authors: Mechtouff, Laura, Nighoghossian, Norbert, Amaz, Camille, Buisson, Marielle, Berthezène, Yves, Derex, Laurent, Ong, Elodie, Eker, Omer Faruk, Cho, Tae-Hee
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.03.2020; Springer Nature B.V; Springer Verlag
• Subjects: Aged; Angiography, Digital Subtraction - methods; Cerebral Angiography - methods; Clinical outcomes; Female; Hemorrhage; Humans; Ischemia; Life Sciences; Magnetic resonance imaging; Magnetic Resonance Imaging - methods; Male; Medical imaging; Medicine; Medicine & Public Health; Middle Aged; Multivariate analysis; Neuroimaging - methods; Neurology; Neuroradiology; Neurosciences; Occlusion; Original Communication; Retrospective Studies; Stroke; Stroke - diagnostic imaging; Stroke - pathology; Stroke - surgery; Substantia alba; Thrombectomy - methods; Treatment Outcome; White Matter - diagnostic imaging; White Matter - pathology; Thrombectomy; Ischemic stroke; Magnetic resonance imaging; White matter
• ISSN: 0340-5354; 1432-1459; 1432-1459
• DOI: 10.1007/s00415-019-09624-2

Background and purpose The significance of white matter hyperintensities (WMHs) in the setting of mechanical thrombectomy (MT) remains poorly documented. We assessed whether pre-existing WMHs burden was associated with baseline clinical and imaging factors and neurological outcome in patients undergoing MT. Methods This retrospective single-center study included consecutive acute ischemic stroke (AIS) patients with stroke due to large vessel occlusion treated with MT. WMHs were assessed on baseline T2 fluid-attenuated inversion recovery magnetic resonance imaging. Neurological outcome was assessed at day 90 by the modified Rankin Scale (mRS). We analyzed the association between WMH burden and clinical and imaging factors by univariate and multivariate logistic regression analyses. Results Between July 2013 and June 2019, 293 patients with anterior circulation AIS met the inclusion criteria. WMHs burden was not associated to baseline NIHSS score severity (OR 0.89, 95% CI 0.54–1.49, p  = 0.66), poor collateral status, Higashida score < 3 (OR 1.5 95% CI 0.62–3.56, p  = 0.36), higher DWI volume (OR 0.69, 95% CI 0.41–1.15, p  = 0.16) or to a lower recanalization rate, TICI 0/2a (OR 0.98 95% CI 0.56–1.69, p  = 0.95). WMHs severity did not influence the risk of parenchymal hemorrhage (OR 0.97 95% 0.26–3, p  = 0.96). WMHs burden was not an independent predictor of poor outcome in multivariate analysis. The rate of futile recanalization in patients with TICI grades 2b and 3 according to mRs score at 3 months was not influenced by WMHs burden. Conclusions WMHs burden does not seem to influence clinical outcome and imaging parameters in patients treated by MT.