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• Clinical Article •
Correlation between arterial recanalization and the susceptibility vessel sign following endovascular therapy in patients with acute ischemic stroke
GENG Yue  ZHANG Mi  WANG Lujiahui  CHEN Juping  LI Junchen  QIAN Xin  CHEN Yu'ang  TAN Yanhuan 

DOI:10.12015/issn.1674-8034.2026.01.006.


[Abstract] Objective To investigate the relationship between arterial recanalization after endovascular treatment and the length and width of the susceptibility vessel sign (SVS), and to evaluate the relationship between successful arterial recanalization after endovascular treatment and various risk factors.Materials and Methods We retrospectively analyzed the patients with anterior circulation ischemic stroke who underwent magnetic resonance imaging (MRI) of the head and susceptibility-weighted imaging (SWI) before endovascular treatment, and measured the SVS length and width. To reduce the variation of SVS width caused by different parts and individual differences, divide the width of the SVS on the affected side by the width of the healthy blood vessel to obtain the relative width of the SVS. At the end of endovascular treatment, those who achieved an assessment of 2b50-3 in the expanded thrombolysis in cerebral infarction (eTICI) were classified as the successful recanalization group, while those who did not reach this level were classified as the unsuccessful recanalization group. Stepwise regression was used to screen variables, and the indicators with statistically significant differences were included in the multivariate logistic regression analysis to determine the independent predictors of successful recanalization and first-pass reperfusion (FPR) after endovascular treatment.Results Among 112 patients, 79 cases achieved successful recanalization and 33 cases did not,within the successful recanalization group, there were 39 cases of FPR. The median width of SVS in the successful recanalization group and the unsuccessful recanalization group was 4.3 (4.1, 4.6) mm and 3.2 (3.0, 3.9) mm, respectively, with P < 0.001, indicating a statistically significant difference; the median length of SVS was 10.6 (9.5, 13.1) mm and 10.5 (7.5, 14.5) mm, respectively, with P = 0.871, indicating no statistically significant difference. In the multivariate logistic regression analysis, SVS width was associated with successful recanalization [odds ratio = 3.025; 95% confidence interval (CI): 4.895 to 24.564; P = 0.001] and FPR (odds ratio = 9.243; 95% CI: 3.493 to 14.460; P < 0.001). The optimal cutoff value for the SVS width to predict successful recanalization and FPR were 3.95mm and 3.85 mm, respectively.Conclusions The width of SVS is a potential imaging biomarker for predicting successful reperfusion of arteries and FPR after endovascular treatment. The length of SVS has no significant predictive value.
[Keywords] acute ischemic stroke；endovascular treatment；magnetic resonance imaging；susceptibility-weighted imaging；susceptibility vessel sign

GENG Yue1   ZHANG Mi1   WANG Lujiahui1   CHEN Juping2   LI Junchen1   QIAN Xin1   CHEN Yu'ang1   TAN Yanhuan1*  

1 Department of Radiology, Changshu Hospital Affiliated to Nanjing University of Chinese Medicine, Changshu 215500, China

2 Department of Neurology, Changshu Hospital Affiliated to Nanjing University of Chinese Medicine, Changshu 215500, China

Corresponding author: TAN Y H, E-mail: tanyanhuan@njucm.edu.cn

Conflicts of interest   None.

Received  2025-09-09
Accepted  2025-12-23
DOI: 10.12015/issn.1674-8034.2026.01.006
DOI:10.12015/issn.1674-8034.2026.01.006.

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