Angiographic assessment of lenticulostriate artery sign to predict clinical outcomes after thrombectomy in patients with stroke.

Objective: Lenticulostriate artery (LSA) reperfusion is critical for basal ganglia blood supply. Basal ganglia infarction (BGI) inconveniencing patients with large artery occlusion and occluded perforators may influence clinical outcomes. This study aims to investigate the association between LSA recanalization, BGI, and long-term outcome after thrombectomy in the ischemic hemisphere. Methods: In total, 158 stroke patients who underwent thrombectomy were included in this study. Clinical and imaging variables were retrospectively analyzed. LSA signs were categorized as presence (LSA+) or absence (LSA-) of clear vascular patency in the ischemic hemisphere at on-going and post recanalizations. Logistic regression was used to test the relationship between baseline clinical and imaging variables and BGI (primary outcome). The secondary outcome was 90-day modified Rankin Scale (mRS) >2. Results: Good functional outcome (mRS ≤2, 41.8%) varied among LSA sign patterns. In the multivariate analysis, LSA sign patterns were significantly associated with both BGI and 90 days mRS >2. The odds ratios of LSA-/- and LSA+/LSA- patterns in BGI and long-term outcome remained significant after adjustment of confounders. Models comprising LSA patterns achieved AUC of 0.74 for BGI and 0.91 for long-term outcome. Conclusion: LSA signs before and after thrombectomy were significantly associated with BGI and long-term functional outcome. This may be a potential predictor of regional ischemic vulnerability and long-term recovery in patients with stroke.