PT - JOURNAL ARTICLE AU - Rishi Gupta AU - Chung-Huan Johnny Sun AU - Dustin Rochestie AU - Kumiko Owada AU - Ahmad Khaldi AU - Andrew K Johnson AU - Christopher M Horn TI - Presence of the hyperintense acute reperfusion marker on MRI after mechanical thrombectomy for large vessel occlusion is associated with worse early neurological recovery AID - 10.1136/neurintsurg-2016-012498 DP - 2017 Jul 01 TA - Journal of NeuroInterventional Surgery PG - 641--643 VI - 9 IP - 7 4099 - http://jnis.bmj.com/content/9/7/641.short 4100 - http://jnis.bmj.com/content/9/7/641.full SO - J NeuroIntervent Surg2017 Jul 01; 9 AB - Background Mechanical thrombectomy has become the accepted treatment for large vessel occlusion in acute ischemic stroke. Unfortunately, a large cohort of patients do not achieve functional independence with treatment, even though the results are more robust than with medical management. The hyperintense acute reperfusion marker (HARM) on MRI is an indication of the breakdown of the blood–brain barrier and reperfusion injury.Objective To examine the hypothesis that the presence of HARM on MRI correlates with worse neurological recovery after reperfusion therapy.Methods We retrospectively reviewed 35 consecutive patients who between February 24, 2016 and April 23, 2016 underwent MRI to determine the presence of HARM after thrombectomy for anterior circulation large vessel occlusion. Demographic, radiographic imaging, and outcome data were collected. Univariate and binary logistic regression models were performed to assess predictors for improvement of the National Institutes of Health Stroke Scale (NIHSS) score by ≥8 points at 24 hours.Results The 35 patients studied had an average age of 64±14 years of age with a median NIHSS score of 15 (IQR 9–20). Eighteen patients (51%) were found to have a HARM-positive MRI. In univariate analysis, patients with HARM were older, had lower reperfusion rates and more postprocedural hemorrhages. In binary logistic regression modeling, the absence of HARM was independently associated with a ≥8-point NIHSS score improvement at 24 hours (OR=7.14, 95% CI 1.22 to 41.67).Conclusions This preliminary analysis shows that the presence of HARM may be linked to worse neurological recovery 24 hours after thrombectomy. Reperfusion injury may affect the number of patients achieving functional independence after treatment.