• Sarah Power, Charles Matouk, Leanne K Casaubon, Frank L Silver, Timo Krings, David J Mikulis, and Daniel M Mandell.
• From the Division of Neuroradiology, Department of Medical Imaging, University of Toronto and the Toronto Western Hospital, Toronto, Ontario, Canada (S.P., T.K., D.J.M., D.M.M.); Department of Neurosurgery (C.M.) and Department of Diagnostic Radiology (C.M.), Yale University School of Medicine, New Haven, CT; and Division of Neurology, Department of Medicine, University of Toronto and the Toronto Western Hospital, Toronto, Ontario, Canada (L.K.C., F.L.S.).
• Stroke. 2014 Aug 1;45(8):2330-4.

Background And PurposeThe aim of the study was to determine the effects of thromboembolism and mechanical thrombectomy on the vessel wall magnetic resonance imaging (VW-MRI) appearance of the intracranial arterial wall.MethodsThis was a cross-sectional study of consecutive patients with acute intracranial arterial occlusion who underwent high-resolution contrast-enhanced VW-MRI within days of stroke presentation. For each patient, we categorized arterial wall thickening and enhancement as definite, possible, or none using contralateral arteries as a reference standard. We performed χ(2) tests to compare the effects of medical therapy and mechanical thrombectomy.ResultsSixteen patients satisfied inclusion criteria. Median time from symptom onset to VW-MRI was 3 days (interquartile range, 2 days). Among 6 patients treated with mechanical thrombectomy using a stent retriever, VW-MRI demonstrated definite arterial wall thickening in 5 (83%) and possible thickening in 1 (17%); there was definite wall enhancement in 4 (67%) and possible enhancement in 2 (33%). Among 10 patients treated with medical therapy alone, VW-MRI demonstrated definite arterial wall thickening in 3 (30%) and possible thickening in 2 (20%); there was definite wall enhancement in 2 (20%) and possible enhancement in 2 (20%). Arterial wall thickening and enhancement were more common in patients treated with mechanical thrombectomy than with medical therapy alone (P=0.037 and P=0.016, respectively).ConclusionsMechanical thrombectomy results in intracranial arterial wall thickening and enhancement, potentially mimicking the VW-MRI appearance of primary arteritis. This arterial wall abnormality is less common in patients with arterial occlusion who have been treated with medical therapy alone.© 2014 American Heart Association, Inc.

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