Application of high-resolution magnetic imaging in the perioperative period of mechanical thrombectomy for acute intracranial large artery occlusion

Background: High-resolution magnetic resonance imaging (HR-MRI) holds promise for guiding the perioperative management of acute intracranial large artery occlusion during mechanical thrombectomy. Materials and Methods: A retrospective analysis was conducted on patient data from Tianjin Huanhu Hospital, March to September 2020. Patients underwent preoperative imaging, including head CT, MRI, MRA, and HR -MRI. Surgical plans were based on HR-MRI findings, with outcomes assessed using NIHSS, ASPECT score, mTICI grading, complications, and 90-day/24-month mRS scores. Results: Among 22 patients, 19 achieved successful recanalization, with two cases halted due to calcified plaque obstruction and one due to basilar artery difficulty. No perioperative hemorrhage or mortality occurred. Discharge NIHSS median was 3.4 (range 2.7-3.8). Follow-up (median 14 months) showed no deaths or loss. Median mRS score for successful cases was 1 (range 1-3), with two new strokes and one TIA. Two patients experienced restenosis, promptly treated with stenoplasty. Conclusions: HR-MRI enhances the perioperative assessment of mechanical thrombectomy for acute intracranial large artery occlusion, aiding in lesion characterization, occlusion length determination, and identification of critical vessel relationships. This approach facilitates safer and more effective emergency thrombectomy procedures.