The Utility of a Diagnostic Angiogram Following Mechanical Thrombectomy for Treatment of Acute Ischemic Stroke

Abstract Objective Digital subtraction angiography is the gold standard for diagnosis of vascular pathology. The value of angiography of non-target vessels following mechanical thrombectomy for the treatment of acute ischemic stroke (AIS) is unknown. Patients and Methods Consecutive patients treated with mechanical thrombectomy for AIS due to large vessel occlusion (LVO) at an academic institution between February 2016 and December 2018 were retrospectively reviewed. Demographic information, clinical data, and procedure details were recorded. Descriptive statistics were used to evaluate the utility of non-target vessel angiography. Results One hundred and fifty-six patients presenting with AIS due to LVO were treated with 159 mechanical thrombectomy procedures. Median age was 71.5 years. Ninety-one (57.2 %) procedures were followed with a diagnostic cerebral angiogram of non-target vessels. Previously unknown findings were identified in 4 (4.4 %) procedures. Management change due to the non-target vessel angiogram finding occurred in 3 (3.3 %) cases and included one contralateral mechanical thrombectomy. No complications occurred as a result of the non-target vessel angiogram. Conclusion Angiographic imaging of non-target vessels following mechanical thrombectomy identified previously unknown vascular pathology in 4.4 % of procedures and resulted in a clinical management change in 3.3 % of cases.