Hyperdense sign as a predictor for successful recanalization and clinical outcome in acute ischemic stroke: A systematic review and meta-analysis

Author:

Gharaibeh Khaled12ORCID,Aladamat Nameer1,Samara Mohammad1,Mierzwa Adam T.12,Ali Ahsan12,Zaidi Syed12,Jumaa Mouhammad12

Affiliation:

1. Department of Neurology, University of Toledo College of Medicine, and Life Sciences, Toledo, OH, USA

2. Promedica Stroke Network, Toledo, OH, USA

Abstract

Objective To assess the prognostic values of hyperdense sign on pretreatment non-contrast head CT scan for successful recanalization (mTICI ≥2b) and 90-day good functional outcome (mRs 0-2) in patients with acute ischemic stroke undergoing mechanical thrombectomy (MT). Methods Literature search on PubMed, EMBASE, and Cochrane databases from inception up to 1 November 2023 was conducted. Twelve studies which reported hyperdense sign, recanalization and clinical outcomes were included in qualitative synthesis and meta-analysis. Results Pooled analysis demonstrated a statistically significant association between successful recanalization and hyperdense sign-positive patients who underwent MT (odd ratios (OR) = 1.47, 95% confidence interval (CI) = 1.03–2.10, p = 0.04). No statistically significant association was demonstrated between presence of hyperdense sign and good functional outcome (OR = 1.04, 95% CI: 0.72–1.49, p = 0.85) or symptomatic intracranial hemorrhage sICH (OR: 1.80, 95% CI 0.72–4.47, p = 0.21) Conclusions This meta-analysis demonstrated that pre-intervention hyperdense sign on CT imaging might be useful in prediction of successful recanalization after MT.

Publisher

SAGE Publications

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