Article Figures & Data
Figures
- Fig 1.
An 85-year-old man with right-sided hemiparesis and aphasia (NIHSS 13). Pretreatment SWI shows susceptibility vessel signs in the left M1 and M2 segments (A, white arrows). On TOF-MRA (MIP), diminished flow signal is seen distal to the thrombus fragment in the M1 segment with complete loss of flow signal at the site of the distal thrombus fragment (B, white arrowheads). DSA demonstrates incomplete occlusion of the vessel lumen by a thrombus in the M1 segment (C, anteroposterior projection, black arrowhead). On the lateral projection, occlusion of the temporo-occipital M2 branch by a more distal thrombus fragment is visible (D, black arrow). Although both TOF-MRA and DSA can show the distal vessel occlusion, only SWI allows estimation of the length of the distal fragment and exclusion of additional distal thrombi.
- Fig 2.
A 69-year-old male patient with a sudden decrease in consciousness. SWI shows susceptibility artifacts from thrombotic material in the basilar artery (A, white arrow) and the right posterior cerebral artery (B, white arrowhead). Hemorrhagic transformation of a subacute infarction in the vascular territory of the right posterior cerebral artery is seen. DSA confirms occlusion of the basilar artery (C, anteroposterior projection, black arrowhead). Following successful endovascular recanalization of the basilar artery, the occlusion in the perimesencephalic segment of the right posterior cerebral artery, already known from pretreatment SWI, becomes visible in DSA as well (D, anteroposterior projection, black arrow).
Tables
Fragmented Thrombus (n = 24) (7.4%) Single Thrombus (n = 300) (92.6%) P Age (yr) (mean) (SD) 73.1 (11.3) 68.6 (14.0) .109 Women (No.) (%) 9 (37.5) 139 (46.3) .403 Baseline NIHSS score (median) (range) 15 (6–36) 11 (1–36) .014 Vascular risk factors Hypertension (No.) (%) 15 (62.5) 192 (64.0) .883 Diabetes mellitus (No.) (%) 5 (20.8) 45/298 (15.1) .395 Atrial fibrillation (No.) (%) 13/23 (56.5) 123/263 (46.8) .392 Current smoking (No.) (%) 2/22 (9.1) 57/286 (19.9) .271 Hypercholesterolemia (No.) (%) 14/23 (60.9) 161/296 (54.4) .548 Coronary artery disease (No.) (%) 5 (20.8) 58/298 (19.5) .794 Previous stroke (No.) (%) 2 (8.3) 31/298 (10.4) 1.00 Stroke etiology .558 Large artery disease (No.) (%) 3 (12.5) 31 (10.3) Cardioembolic stroke (No.) (%) 14 (58.3) 135 (45.0) Other determined etiology (No.) (%) 2 (8.3) 38 (12.7) Unknown etiology (No.) (%) 5 (20.8) 96 (32.0) Fragmented Thrombus (n = 24) (7.4%) Single Thrombus (n = 300) (92.6%) P Affected vascular territory .739 Anterior circulation (No.) (%) 21 (87.5) 267 (89.0) Posterior circulation (No.) (%) 3 (12.5) 33 (11.0) Occlusion site .372 Tandem occlusion (No.) (%) 3 (12.5) 29 (9.7) Carotid-T (No.) (%) 3 (12.5) 14 (4.7) MCA M1 (No.) (%) 8 (33.3) 123 (41.0) MCA M2 (No.) (%) 6 (25.0) 74 (24.7) MCA M3/4 (No.) (%) 1 (4.2) 23 (7.7) Anterior cerebral artery (No.) (%) 0 (0.0) 4 (1.3) Basilar artery (No.) (%) 3 (12.5) 16 (5.3) Posterior cerebral artery (No.) (%) 0 (0.0) 17 (5.7) Primary thrombus length on SWI (mm) (mean) (SD) 10.3 (6.4) (n = 18) 10.3 (5.6) (n = 248) .699 Total clot length (mm) (mean) (SD) 20.1 (10.7) (n = 18) 10.3 (5.6) (n = 248) <.001 DWI ASPECTS (media) (range) 5 (0–8) (n = 21) 7 (0–10) (n = 263) .006 Leptomeningeal collaterals n = 19 n = 199 .051 Good (No.) (%) 4 (21.1) 88 (44.2) Moderate/poor (No.) (%) 15 (78.9) 111 (55.8) Treatment .625 Intravenous thrombolysis only (No.) (%) 6 (25.0) 102 (34.0) Bridging thrombolysis (No.) (%) 7 (29.2) 69 (23.0) Endovascular intervention only (No.) (%) 11 (45.8) 129 (43.0) Fragmented Thrombus (n = 24) (7.4%) Single Thrombus (n = 300) (92.6%) P Symptomatic intracranial hemorrhage (No.) (%) 3 (12.5) 17 (5.7) .176 Asymptomatic intracranial hemorrhage (No.) (%) 6 (25.0) 34 (11.3) .097 Favorable outcome (mRS 0–2) at 3 months (No.) (%) 6/23 (26.1) 171/286 (59.8) .002 Death at 3 months (No.) (%) 7/23 (30.4) 43/292 (14.7) .069
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