Abstract 2674: DWI Reversal is associated with Small Infarct Volume and Early Reperfusion in Patients with TIA and Minor Stroke. Data from VISION and CATCH study groups

• DOI: 10.1161/str.43.suppl_1.a2674
• Publication Date: 2021-07-03T11:03:18Z
• Authors: Negar Asdaghi; Jonathan I Coulter; Jayish Modi; Abdul Qazi; Mayank Goyal; ken S Butcher; Michael D Hill; Andrew M Demchuk; Shelagh B Coutts
• Keywords: Penumbra; Fluid-attenuated inversion recovery; Stroke

Introduction: One-third of patients with TIA and minor ischemic stroke (MIS) have evidence penumbra, defined as hypoperfused regions that not been irreversibly damaged. Diffusion weighted Imaging (DWI) lesions are thought to represent damaged tissue. DWI reversal therefore has implications in accurate estimation penumbra. We aimed determine the rate this population. Methods: Patients TIA/MIS (NIH Stroke Scale ≤ 3) were prospectively enrolled imaged within 24 hours symptom onset part two prospective imaging cohorts. included if their baseline modified Rankin scale (mRS) score was ≤1. All followed clinically for 3 months had a repeat MRI either at day 30 or 90. Baseline diffusion perfusion follow-up FLAIR final infarct volumes measured. Results: 418 included; 55.5% 37% PWI (Tmax+2s delay) deficits baseline. A total 337 (81%) imaging. occurred 22/192 (11.5%) who lesion The median time from significantly different between those without (78.6 days, IQR=33.3 vs. 79.7 IQR= 59.4, p=0.65). volume smaller (0.27ml, IQR=0.75 ml) compared did reverse (1.45 ml, IQR=3.8 p<0.001). concurrent (Tmax+2s) less likely (6%) tissue hypoperfusion (20%; p=0.003). 4% penumbral patterns ((Tmax+2s)-DWI) 18% penumbra (p=0.003).Severity greater prolongation Tmax (+2,+4, +6, +8s) affect likelihood (linear trend p=0.147). No patient mRS ≥2 90 day, 19% infarction on (p= 0.02). Conclusion: is common more occur hypoperfusion. should significant effect accuracy definition. These data suggest early reperfusion correlated better clinical outcome measured by mRS.