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Non-ischemic cerebral enhancing lesions after thrombectomy: a multicentric retrospective French national registry

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Abstract

To report the occurrence of non-ischemic cerebral enhancing (NICE) lesions following mechanical thrombectomy (MT) through the retrospective French nationwide registry of NICE lesions. All thrombectomy capable stroke centers (TSC) in France were invited to fill out a questionnaire disseminated through a trainee-led research network (JENI-RC: Jeunes en Neuroradiologie Interventionnelle-Research Collaborative). NICE lesions were defined according to previous literature as delayed onset punctate, nodular, or annular foci enhancements with peri-lesion edema and vascular distribution in the territory of the MT with no other confounding disease. All 43 TSC French centers responded. Three patients were reported by 3 different centers over a total of 34,824 MT (2015–2020). Patient no. 1 developed symptomatic NICE lesions 8 weeks after MT with combination of aspiration and stentriever for a right middle cerebral artery occlusion. Patient no. 2 developed asymptomatic NICE lesions 5 weeks after MT with direct thromboaspiration for a right middle cerebral artery occlusion. Patient no. 3 developed symptomatic NICE lesions 6 weeks after MT with direct thromboaspiration, and combination of aspiration and stentriever for a basilar artery occlusion. This study provides evidence that NICE lesions following MT are a possible rare complication with a similar presentation as previously described following endovascular aneurysm treatment. Both radiologists and neurologists should be aware of this adverse event and make use of MRI contrast agents in case of unexplained symptoms/images during follow-up after MT.

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Abbreviations

HPE:

Hydrophilic polymer emboli

JENI-RC:

Jeunes en neuroradiologie interventionnelle

NICE:

Non-ischemic cerebral enhancing

SFNR:

French Society of Neuroradiology

TSC:

Thrombectomy capable stroke centers

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Acknowledgements

The authors thank the JENI members for this collaborative study.

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Authors and Affiliations

  1. Neuroradiology Department, University Hospital of Limoges, CHU LIMOGES, 2 avenue Martin Luther-King, 87000, Limoges, France

    Géraud Forestier, Suzana Saleme, Charbel Mounayer & Aymeric Rouchaud

  2. Interventional Neuroradiology Department, Fondation Ophtalmologique Adolphe de Rothschild, Paris, France

    Simon Escalard & Stanislas Smajda

  3. Interventional Neuroradiology Department, Nice University Hospital, Nice, France

    Jacques Sedat & Yves Chau

  4. XLIM CNRS, UMR7252, Université de Limoges, Limoges, France

    Charbel Mounayer & Aymeric Rouchaud

  5. Neurology Department, University Hospital of Limoges, Limoges, France

    Alexis Montcuquet

  6. Neuro-Intensive Care Unit, Fondation Ophtalmologique Adolphe de Rothschild, Paris, France

    Marie Cantier & Charles Gregoire

  7. Neurology Department, Centre Hospitalier de Saint Denis, Hôpital Delafontaine, Saint-Denis, France

    Karolina Hankiewicz

  8. Unité Neurovasculaire, Hôpital La Timone, CHU de Marseille, Marseille, France

    Laurent Suissa

  9. Neuroradiology Department, University Hospital of Bordeaux, Bordeaux, France

    Jérôme Berge

  10. Department of Neuroradiology, Pitié-Salpêtrière Hospital, Paris, France

    Frédéric Clarençon & Eimad Shotar

Authors
  1. Géraud Forestier
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  2. Simon Escalard
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  3. Jacques Sedat
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  4. Suzana Saleme
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  5. Charbel Mounayer
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  6. Alexis Montcuquet
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  7. Stanislas Smajda
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  8. Marie Cantier
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  9. Charles Gregoire
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  10. Karolina Hankiewicz
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  11. Yves Chau
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  12. Laurent Suissa
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  13. Jérôme Berge
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  14. Frédéric Clarençon
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  15. Aymeric Rouchaud
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  16. Eimad Shotar
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Consortia

on behalf of the JENI Research collaboration

Contributions

Study design (GF, AR, FC, ES); data analysis (GF, ES); drafted the manuscript (GF); data acquisition (SE, JS, GF, SS, AM, LS, KH); revised and gave final approval for the manuscript (all authors).

Corresponding author

Correspondence to Géraud Forestier.

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Conflict of interest

AR reports conflict of interest (unrelated) with Bal Extrusion. FC reports conflict of interest (unrelated) with Medtronic, Guerbet, Balt Extrusion (payment for readings), Codman Neurovascular (core lab).

The other authors report no disclosures relevant to the manuscript.

Ethical approval

The CERIM (Comité d’Ethique pour la Recherche en Imagerie Médicale) institutional review board approved this study (CRM-1912–045). The need for patient informed consent was waived for retrospective analyses of patients’ records. Data shall be made available upon reasonable request to the corresponding author.

Informed consent

Not required. According to national legislation, the need for signed patient informed consent was waived for retrospective analyses of patients’ records and imaging data.

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Forestier, G., Escalard, S., Sedat, J. et al. Non-ischemic cerebral enhancing lesions after thrombectomy: a multicentric retrospective French national registry. Neuroradiology 64, 1037–1042 (2022). https://doi.org/10.1007/s00234-022-02919-8

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  • DOI: https://doi.org/10.1007/s00234-022-02919-8

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