ABSTRACT NUMBER: ESOC2026A98 DIAGNOSTIC YIELD OF HIGH-RESOLUTION VESSEL WALL MAGNETIC RESONANCE IMAGING IN THE EVALUATION OF TRANSIENT ISCHEMIC ATTACK (TIA) PATIENTS

Abstract Background and aims Patients with TIA are high risk for stroke. Intracranial vessel wall imaging (icVWI) has become an essential tool for clinicians in assessing the cause of stroke. We aimed to evaluate the role of icVWI in determining TIA etiology, pathogenesis and management. Methods We retrospectively analyzed patients with TIA admitted to a single tertiary academic center and compared between patients that underwent icVWI as part of their diagnostic workup those who did not have icVWI. We further compared patients with intracranial vulnerable plaques on to icVWI those with negative icVWI findings. Stroke occurrence during follow-up was documented. Results Of 453 screened TIA patients, 152 (33%) underwent icVWI. These patients were more often treated with dual antiplatelet therapy (81.4% vs. 69.5%, p=0.002) upon discharge. Recurrent TIA was more common in the icVWI group (13% vs. 5%, p=0.004) but other characteristics did not differ. Among icVWI patients, 52 patients (34%) had evidence of vulnerable plaques. Plaque enhancement (100%) and vessel wall remodeling (54%) were the most common findings on icVWI. Patients with positive icVWI were more often treated with dual antiplatelet for more than 3 weeks (29% vs 10%, p=0.009). Stroke occurrence was rare (8%), did not differ between groups. Conclusions icVWI adds significant information relevant to TIA pathogenesis, prevention and management and should be considered in all patients with TIA. Conflict of interest nothing to disclose