Prognostic Value of Cerebral Hemodynamics Assessment on 24‐h Transcranial Color‐Coded Doppler Following a Successful Thrombectomy
Year: 2025
Type: article
Study design: Observational Study
Abstract: BACKGROUND AND AIMS: This study evaluates the distribution and prognostic role of transcranial color-coded Doppler (TCCD) spectral patterns following a successful endovascular thrombectomy (EVT). METHODS: This multicenter prospective study included patients with internal carotid or middle cerebral artery (MCA) occlusion treated in the early time window (< 6 h) with a successful EVT (mTICI ≥ 2b), without symptomatic hemorrhagic transformation within 24 h. TCCDs were performed 24-48 h and 7 days from EVT. TCCD flow was graded by Consensus on Grading Intracranial Flow Obstruction (COGIF) score (1: no flow; 2-3: low flow; 4a: normal; 4b: residual stenosis; 4c: hyperperfusion). MCA flow velocities were compared between sides and time points. Outcomes were clinical improvement (decrease of 8 points/30% on day 7 NIHSS vs. baseline) and three-month mRS. RESULTS: 188 ischemic stroke patients were included (48% female, median age 77). The median NIHSS was 16 at admission and 3 at day 7. Day 1 TCCD showed slightly higher velocities in the treated MCA compared to the contralateral MCA, without significant differences between day 1 and day 7. Despite mTICI ≥ 2b, 13/187 (7%) patients showed a partial recanalization or residual stenosis at 24 h. Clinical improvement was lacking in 27 patients (14.4%). COGIF scores 3 and 4b at day 1 were significantly associated with lack of improvement at day 7 (aOR 0.03, 95% CI 0.01-0.16, p < 0.001) and worse mRS score at 3 months (mRS ordinal shift analysis, aOR 7.78, 95% CI 2.16-28.54, p = 0.002). CONCLUSIONS: Day 1 post-EVT TCCD COGIF score, but no flow velocities alone, are associated with clinical outcomes.
Source: European Journal of Neurology
DOI: 10.1111/ene.70224
Authors: Sabrina Rossi, Matteo Paolucci, Giorgia Arnone, Guido Bigliardi, Marco Longoni, Giuseppe Pulito, Cristiano Azzini, Lorenzo Coppo, Monia Russo, Georgios Tsivgoulis, Odysseus Kargiotis, Vincenzo Inchingolo, Vittoria Maria Sarra, Daniela Monaco, Ludovica Migliaccio, Riccardo Ricceri, Michele Romoli, Donatella Mastria, Maura Pugliatti, Mauro Gentile, Andrea Zini, Giovanni Malferrari, The HYs Study Group
Institutions: University of Ferrara, Arcispedale Sant'Anna, Ospedale Maggiore Carlo Alberto Pizzardi, Istituto delle Scienze Neurologiche di Bologna, Azienda Ospedaliero-Universitaria di Modena, Azienda Unità Sanitaria Locale Della Romagna, Ospedale Vito Fazzi, Azienda Ospedaliero Universitaria Maggiore della Carita, Ospedale Santa Maria della Misericordia di Rovigo, National and Kapodistrian University of Athens, University General Hospital Attikon, Metropolitan Hospital, Casa Sollievo della Sofferenza, Azienda sanitaria universitaria Giuliano Isontina
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,600
OpenAlex ID: W4410860615