Article Figures & Data
Figures
- Fig 1.
Flowchart of study inclusion.
- Fig 2.
An 85-year-old man with an occlusion of the left M1–M2 segment (arrow), successfully treated with a thrombosuction device (patient 9 in Table 2). A, Digital subtraction angiography directly before and after the thrombectomy procedure. B, Subtraction image from coregistered pre- and postcontrast vessel wall images confirms a hyperintense configuration at the thrombectomy site. The transverse pre- (C) and postcontrast (D) MPIR-TSE vessel wall images at 7T (voxel size = 0.8 × 0.8 × 0.8 mm3) were obtained 22 days after thrombectomy procedure. The eccentric vessel wall enhancement present after contrast administration is at the same location as the thrombectomy site (arrow, D).
- Fig 3.
A 72-year-old woman with an occlusion of the right M1 segment, successfully treated with a thrombosuction device (patient 11 in Table 2). Digital subtraction angiography directly before the thrombectomy procedure shows an acute occlusion in the right middle cerebral artery (A, arrow). B, Subtraction image from coregistered pre- and postcontrast (C and D) vessel wall images confirms a hyperintense rim (arrow) at the vessel wall. Transverse pre- (C) and postcontrast (D) MPIR-TSE vessel wall images at 7T were obtained 25 days after the thrombectomy procedure. The area of eccentric vessel wall enhancement (D) is seen in the right M1 segment, at the same location as the thrombectomy site, confirmed on the subtraction image in B (arrows).
- Fig 4.
A 67-year-old man with an occlusion of the left M1–M2 segment, successfully treated with intra-arterial thrombectomy (patient 14 in Table 2). The patient was treated with both a stent-retriever device and a thrombosuction device. Axial pre- (A) and postcontrast (B) MPIR-TSE vessel wall images at 7T, 87 days after the thrombectomy procedure. Clear contrast enhancement is present (white arrows) at the same location where the thrombectomy was performed. The carotid and basilar arteries appear normal (white arrowheads, A and B). C, Subtraction image of the pre- and postcontrast vessel wall images confirms the enhancement at the same location. D and E, Coronal views of the postcontrast MPIR-TSE vessel wall images show enhancement over a long trajectory of the left M1 and M2 segments. F, Sagittal view of the postcontrast MPIR-TSE vessel wall image shows that the enhancement has a concentric configuration.
- Fig 5.
A 75-year-old woman with an anterior circulation ischemic infarction of the left MCA territory (non-IAT group, patient 30 in On-line Table). Transverse and coronal precontrast (A and C) and postcontrast (B and D) MPIR-TSE vessel wall images at 7T were obtained 10 days after symptom onset of the ischemic infarction. Note eccentric vessel wall enhancement of the supraclinoid portion of both intracranial carotid arteries (B and D, arrows). The basilar artery appears normal (white arrowheads, A and B).
Tables
IAT Total (%) Non-IAT Total (%) P Value Age (mean) (range) (yr) 65 (42–85) 60 (35–81) .23a Sex (male) 10 (71%) 18 (51%) .34b Hypertension 4 (29%) 18 (51%) .21b Hyperlipidemia 7 (50%) 18 (51%) .99b Diabetes mellitus 0 (0%) 4 (11%) .31b Current smoking 3 (21%) 12 (34%) .46c Former smoking 5 (36%) 7 (20%) .46c Atrial fibrillation 3 (21%) 4 (11%) .39b NIHSS score (mean) (range) 10.5 (3–20) 6.3 (0–21) .02a TOAST criteria30 .62c Large-artery atherosclerosis 7 (50%) 21 (60%) Cardioembolism 4 (29%) 5 (14%) Small-vessel occlusion 0 (0%) 0 (0%) Other determined etiology 1 (7%) 5 (14%) Undetermined 2 (14%) 4 (12%) Time to 7T MR imaging (mean) (SD) (day) 55 (±22) 16 (±23) <.001a Time to 7T MR imaging (median) (range) (day) 58 (22–87) 6 (1–84) - Table 2:
Location of occlusion and treatment details, including detected enhancing vessel wall foci, in the IAT-groupa
Patient No. Occlusion Site NIHSS Score NOP Time Symptom Onset to IAT (Min) Procedural Time (Min) TICI Score Alteplase Time IAT to MRI (Day) Ipsilateral Enhancing Foci Contralateral Enhancing Foci 1 M1 right 10 1 190 35 TICI 3 Yes 33 – – 2 M1–M2 right 11 1 208 34 TICI 3 Yes 67 – M1-E 3 Distal carotid left 8 3 318 50 TICI 2b No 84 M1-C – 4 M2 left 5 5 170 83 TICI 2b Yes 49 ICA-E, M2-E ICA-E 5 M2 left 5 1 127 42 TICI 3 Yes 65 – – 6 (Large) M3 right 3 1 135 60 TICI 0 Yes 67 ICA-C – 7 Distal carotid left 12 2 201 60 TICI 2b Yes 80 ICA-C – 8 M2 left 4 3 275 70 TICI 2b No 59 ICA-C, M1-E ICA-E 9 M1–M2 left 15 1 150 35 TICI 3 Yes 22 M1-E – 10 M1 left 14 1 150 39 TICI 3 Yes 24 M1-E – 11 M1 right 12 1 145 29 TICI 3 Yes 25 ICA-E 2x, M1-E – 12 M1–M2 right 20 1 76 40 TICI 3 Yes 51 – – 13 M1 right 15 0 44 42 TICI 3 Yes 57 – – 14 M1–M2 left 14 2 180 50 TICI 2b Yes 87 M1-C, M2-C – Note:—C indicates concentric; E, eccentric; M, segment of the middle cerebral artery (M1 and M2); NOP, number of passes; –, no enhancing foci detected.
↵a Treatment details of the 14 patients including the number and location of the detected foci of contrast enhancement (by A.G.v.d.K.). In patient 3, the enhancing focus detected in the M1 segment was located distal to the occlusion but directly adjacent to the occlusion site and therefore identified as the same location as the thrombosuction site.
- Table 3:
Comparison of enhancing foci between the IAT-group and the non-IAT group and between the ipsilateral and contralateral sides
IAT-Group Non-IAT Group P Value Total No. of enhancing foci 21.5 30 .04a Total No. of ipsilateral enhancing foci 18.5 18.0 .003a Total No. of contralateral enhancing foci 3.0 12.0 .74a Total No. of concentric ipsilateral foci 9.0 8.5 .02a Total No. of eccentric ipsilateral foci 9.5 9.5 .07a Total No. of enhancing foci ipsilateral vs contralateral (proportion) P value (18.5 vs 3.0) .005b (18.0 vs 12.0) .47b Total No. of concentric enhancing foci ipsilateral vs. contralateral (proportion) P value (9.0 vs 0.0) .011b (8.5 vs 3.0) .14b Total No. of eccentric enhancing foci ipsilateral vs. contralateral (proportion) P value (9.5 vs 3.0) 06b (9.5 vs 9.0) .97b
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