Infarct Volume Often Increases After Complete Recanalization for Large Vessel Occlusion

Infarct volume on diffusion-weighted imaging (DWI) increased after complete recanalization in 85.7% (median change 4.4 mL); each decile increase in volume change lowered odds of 90-day functional independence (aOR 0.81, 95%CI 0.68–0.97).

• Baseline CT perfusion core was method-sensitively associated with greater volume change in a model without immediate DWI (β=0.154, bootstrap P=0.014), but this was attenuated after adjusting for immediate DWI, supporting a possible mediated rather than independent pathway.
• Delayed DWI showed the best outcome discrimination.
• From a multicenter registry of 189 anterior-circulation LVO patients with TICI 3 recanalization who had pre-thrombectomy CTP and serial DWI.

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