Abstract TP135: Age-Related Differences in DWI Lesion Volume and Reversal in Patients With Recanalization After Mechanical Thrombectomy for Large Vessel Occlusion

Abstract

Background and Purpose: With the development of mechanical thrombectomy (MT) for large vessel occlusion (LVO), post-treatment DWI lesion reversal (DWIR) has been reported. We aimed to retrospectively compare baseline and post-treatment DWI lesion volume and the incidence of DWIR between younger and elderly patients who received successful recanalization by MT for anterior LVO. Methods: A total of 177 patients who underwent successful recanalization with MT for occlusion of the anterior LVO between April 2011 and September 2022 were included in our hospital. Patients were divided into two groups: under 70 years of age and over 70 years of age. MRI was performed before and 24 hours after treatment. DWI lesion volume, apparent diffusion coefficient (ADC) value of DWI lesion, and the incidence of DWIR were examined between age groups. Factors associated with DWI lesion volumes were determined by multivariate analysis. Result: The median age of the patients was 78 years, 76 (42.9%) were female, 35 (19.8%) were in the <70 years group, and 142 (80.2%) were in the ≥70 years group. No significant differences existed between the age groups in the distribution of occluded vessels, NIHSS, and time from onset to recanalization. Baseline volume was significantly higher in the <70 years group than in the ≥70 years group (16.0ml vs 4.0ml p<0.001). There was no difference in the ADC value of DWI lesion between the two groups. There was no difference in DWIR between the two groups (65% vs. 55%), but the post-treatment DWI lesion was significantly smaller than the baseline lesion n the <70 years group. was Age being also independent of DWI lesion volume before and after treatment. Conclusions: In patients undergoing recanalization on MT for anterior LVO, baseline DWI lesions were significantly larger in young patients than in elderly patients. Although DWIR was present in over half of both groups, DWI lesion volume was significantly reduced after recanalization in younger patients.