Extracranial ultrasound following mechanical thrombectomy in patients with acute stroke

J Neuroimaging. 2022 Mar;32(2):279-284. doi: 10.1111/jon.12954. Epub 2021 Dec 14.

Abstract

Background and purpose: Mechanical thrombectomy (MT) is standard care for patients suffering from an ischemic stroke due to a large vessel occlusion. Immediate and follow-up transcranial ultrasound examinations after MT were shown to have a diagnostic benefit. However, it is unclear whether repeated extracranial ultrasound after MT has an additional diagnostic yield, that is, depicts new findings.

Methods: Retrospectively, from our prospective database we identified all patients after MT who presented for a follow-up examination between January 2017 and March 2020 and who had received an ultrasound examination after MT and at follow-up. Clinical data were extracted from our database. Ultrasound images of all patients were revisited to identify new findings at follow-up compared to examination after MT.

Results: Ninety-one patients were identified appropriate for further analysis, with a mean age of 67.8 ± 16 years. Median National Institute of Health Stroke Scale at admission was 11 ± 8.5 points. At baseline ultrasound, 18 patients (19.8%) had no atherosclerotic alterations and 73 patients (82.2%) had a plaque burden of ≥1 plaque. During follow-up, in 5 patients (5.5%) a pathological finding presented in first examination evolved dynamically, that is, normalized. Vessel status of all other patients was stable, especially, in no patient a new relevant pathological finding occurred.

Conclusions: Although sonographic normalization of pathologic findings was observed, pathologic new findings were not detected during follow-up. This study provides first data for a discussion of the role of ultrasound in a structured stroke care after MT. However, larger studies are required to improve the understanding.

Keywords: extracranial ultrasound; follow-up; mechanical thrombectomy; stroke.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Brain Ischemia*
  • Humans
  • Middle Aged
  • Retrospective Studies
  • Stroke* / diagnostic imaging
  • Stroke* / surgery
  • Thrombectomy / methods
  • Treatment Outcome
  • Ultrasonography