Abstract #0082

MR microscopy to assess clot composition following mechanical thrombectomy predicts recanalization and clinical outcome

Kianush Karimian-Jazi¹, Dominik Vollherbst¹, Daniel Schwarz¹, Manuel Fischer¹, Katharina Schregel¹, Gregor Bauer², Anna Kocharyan³, Volker Sturm¹, Ulf Neuberger¹, Jessica Jesser¹, Christian Herweh¹, Christian Ulfert¹, Tim Hilgenfeld¹, Fatih Seker¹, Fabian Preisner¹, Niclas Schmitt¹, Tobias Charlet¹, Stefan Hamelmann⁴, Felix Sahm⁴, Sabine Heiland¹, Wolfgang Wick¹, Peter Ringleb², Lucas Schirmer³, Martin Bendszus¹, Markus Möhlenbruch¹, and Michael Breckwoldt¹

¹Neuroradiology, University Hospital Heidelberg, Heidelberg, Germany, ²Neurology, University Hospital Heidelberg, Heidelberg, Germany, ³Neurology, University Hospital Mannheim, Mannheim, Germany, ⁴Neuropathology, University Hospital Heidelberg, Heidelberg, Germany

Synopsis

Keywords: Stroke, Stroke

Motivation: Mechanical thrombectomy (MT) is the standard for ischemic stroke with large vessel occlusion (LVO). Clot composition is underexplored in clinical practice, leading to standardized MT regardless of clot type.

Goal(s): This single-center study examined clot composition in 60 LVO stroke patients using high-field MRI at 9.4T ("MR-microscopy").

Approach: MR microscopy correlated with histopathology, and quantifying the hyperdense artery sign (HAS) on pre-interventional CT further stratified clot composition.

Results: MR microscopy successfully identified clot types—red (23%), white (28%), or mixed (48%)—with 95.4% accuracy. White clots required more passes during MT, had worse clinical outcomes, while red clots showed better first-pass recanalization rates.

Impact: This study suggests clot imaging can personalize MT for improved outcomes in LVO stroke patients.

How to access this content:

For one year after publication, abstracts and videos are only open to registrants of this annual meeting. Registrants should use their existing login information. Non-registrant access can be purchased via the ISMRM E-Library.

After one year, current ISMRM & ISMRT members get free access to both the abstracts and videos. Non-members and non-registrants must purchase access via the ISMRM E-Library.

After two years, the meeting proceedings (abstracts) are opened to the public and require no login information. Videos remain behind password for access by members, registrants and E-Library customers.

Click here for more information on becoming a member.