Abstract #4387

Evaluation of Retrograde Embolization in Cryptogenic Stroke by Aortic 4D flow MRI and 3D TOF MRA

Michael Markl¹, Edouard Semaan¹, LeRoy Stromberg ¹, James Carr¹, Shyam Prabhakaran¹, and Jeremy Collins¹

¹Northwestern University, Chicago, IL, United States

The purpose of this study was to employ aortic 4D flow MRI and brain TOF MRA for the evaluation of retrograde diastolic flow from the descending aorta into the supra-aortic vessels as a mechanism for embolic stroke. In 35 cryptogenic stroke patients, 4D flow MRI demonstrated close to 50% concordance with stroke location on imaging with retrograde diastolic flow into the feeding vessels of the affected cerebral area, identifying a potential etiology for cryptogenic stroke. Our findings further document the importance of taking into account variants in cerebrovascular anatomy which identified retrograde embolization risk in an additional 14% of subjects.

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