Overall cerebral small vessel disease burden is associated with outcome of acute ischemic stroke after mechanical thrombectomy

Abstract

Objectives To investigate the association between the overall cerebral small vessel disease (CSVD) burden and the therapeutic outcome of mechanical thrombectomy (MT) in patients with acute anterior circulation large-vessel occlusion stroke. Materials and Methods Data of patients who achieved successful revascularization after MT for acute anterior circulation large-vessel occlusion stroke in the Ningbo Medical Center Lihuili Hospital between April 2017 and January 2022 were retrospectively analyzed. The overall CSVD burden was evaluated by total CSVD score based on MRI images. According to the 90-day modified Rankin Scale (mRS) score, the participants were divided into the Good outcome group (mRS score 0–2) and Poor outcome group (mRS score 3–6). Multivariate Logistic regression was applied to assess the relationship between the overal CSVD burdern and 90-day outcome. Results In total, 145 eligible patients were included and classified into the Good outcome group (n = 77, 62.3% males, mean age: 64.92 ± 13.67 years) and Poor outcome group (n = 68, 50% males, mean age: 69.76 ± 10.88 years). Symptomatic intracranial hemorrhage (OR = 2.788, 95%CI: 1.143–8.745, P = 0.048), poor preoperative collateral status (OR = 3.619, 95%CI: 1.670–7.844, P = 0.001), and high total CSVD score (score 2: OR = 3.800, 95%CI: 1.173 = 12.311, P = 0.026; score 3: OR = 7.529, 95%CI: 1.555–36.460, P = 0.012) were independently prognostic for poor 90-day outcome in patients receiving MT. Conclusion This study identified that the overall CSVD burden was independently associated with the prognosis of patients receiving MT for acute anterior circulation large-vessel occlusion stroke.

Effect of Cerebral Small Vessel Disease Burden on Infarct Growth Rate and Stroke Outcomes in Large Vessel Occlusion Stroke Receiving Endovascular Treatment

“…In addition, our study showed that a high CSVD burden not only increased the risk of rapid IGR, but also correlated with higher rates of stroke progression and poor functional outcomes at 3 months. The association between CSVD burden and stroke outcomes remains controversial [4,6,31]. Our findings highlight the need for a more comprehensive assessment of CSVD in stroke patients, as it could serve as a potential prognostic factor and guide treatment decisions.…”

“…Cerebral small vessel disease (CSVD) represents a group of pathological features affecting intracranial arterioles, venules, and capillaries that can cause lacunes, white matter hyperintensities (WMH), cerebral microbleeds (CMB), and enlarged perivascular spaces (EPVSs) on neuroimaging [1,2]. Recently, emerging evidence has indicated that CSVD burden increased the worse prognosis in acute ischemic stroke patients with endovascular treatment (EVT) [3][4][5][6].…”