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White matter burden does not influence the outcome of mechanical thrombectomy

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Abstract

Background and purpose

The significance of white matter hyperintensities (WMHs) in the setting of mechanical thrombectomy (MT) remains poorly documented. We assessed whether pre-existing WMHs burden was associated with baseline clinical and imaging factors and neurological outcome in patients undergoing MT.

Methods

This retrospective single-center study included consecutive acute ischemic stroke (AIS) patients with stroke due to large vessel occlusion treated with MT. WMHs were assessed on baseline T2 fluid-attenuated inversion recovery magnetic resonance imaging. Neurological outcome was assessed at day 90 by the modified Rankin Scale (mRS). We analyzed the association between WMH burden and clinical and imaging factors by univariate and multivariate logistic regression analyses.

Results

Between July 2013 and June 2019, 293 patients with anterior circulation AIS met the inclusion criteria. WMHs burden was not associated to baseline NIHSS score severity (OR 0.89, 95% CI 0.54–1.49, p = 0.66), poor collateral status, Higashida score < 3 (OR 1.5 95% CI 0.62–3.56, p = 0.36), higher DWI volume (OR 0.69, 95% CI 0.41–1.15, p = 0.16) or to a lower recanalization rate, TICI 0/2a (OR 0.98 95% CI 0.56–1.69, p = 0.95). WMHs severity did not influence the risk of parenchymal hemorrhage (OR 0.97 95% 0.26–3, p = 0.96). WMHs burden was not an independent predictor of poor outcome in multivariate analysis. The rate of futile recanalization in patients with TICI grades 2b and 3 according to mRs score at 3 months was not influenced by WMHs burden.

Conclusions

WMHs burden does not seem to influence clinical outcome and imaging parameters in patients treated by MT.

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Funding

This work was supported by the RHU MARVELOUS (ANR-16-RHUS-0009) of l’Université Claude Bernard Lyon 1 (UCBL), within the program “Investissements d’Avenir” operated by the French National Research Agency (ANR).

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Author notes

  1. Omer Faruk Eker and Tae-Hee Cho contributed equally to this article.

Authors and Affiliations

  1. Department of Neurology and Comprehensive Stroke Center, Pierre Wertheimer Hospital, Hospices Civils de Lyon, Lyon, France

    Laura Mechtouff, Norbert Nighoghossian, Laurent Derex, Elodie Ong & Tae-Hee Cho

  2. Clinical Investigation Center, INSERM 1407, Louis Pradel Hospital, Hospices Civils de Lyon, Lyon, France

    Camille Amaz & Marielle Buisson

  3. Department of Neuroradiology, Pierre Wertheimer Hospital, Hospices Civils de Lyon, Lyon, France

    Yves Berthezène & Omer Faruk Eker

Authors
  1. Laura Mechtouff
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  2. Norbert Nighoghossian
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  3. Camille Amaz
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  4. Marielle Buisson
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  5. Yves Berthezène
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  6. Laurent Derex
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  7. Elodie Ong
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  8. Omer Faruk Eker
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  9. Tae-Hee Cho
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Corresponding author

Correspondence to Norbert Nighoghossian.

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This research was conducted according to the ethical standards issued by the Declaration of Helsinki.

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Mechtouff, L., Nighoghossian, N., Amaz, C. et al. White matter burden does not influence the outcome of mechanical thrombectomy. J Neurol 267, 618–624 (2020). https://doi.org/10.1007/s00415-019-09624-2

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  • DOI: https://doi.org/10.1007/s00415-019-09624-2

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