ABSTRACT NUMBER: ESOC2026A2371 PIVOTAL STUDY ON ULTRASOUND-BASED MUSCLE CHANGES ASSESSMENT IN ACUTE STROKE PATIENTS

Abstract Background and aims Acute stroke is associated with early morphological/structural changes in skeletal muscle due to reduced mobility/denervation. Ultrasound assessment of the vastus lateralis (VL) muscle, using pennation angle (PA) and muscle thickness (MT), is a non-invasive tool to evaluate early muscle changes; data in the acute stroke phase are limited. This study aimed to study acute stroke patients. Methods Clinical, laboratory, and ultrasound data were collected from 20 patients with acute stroke affecting also one lower limb. Study was conducted between March and September 2025 (Stroke Unit, University Hospital, Trieste). PA and MT of both VL muscles were assessed (affected and unaffected leg) by ultrasound (linear probe, Toshiba Xario 200), at 24–72 hours after symptom onset, with a follow-up assessment at 7 ± 2 days. Results Median age was 79 years (76–83), and median NIHSS at admission was 6 (5–13). Twelve patients underwent reperfusion therapy (five IVT, four IVT + EVT). Ultrasound assessment revealed a slight difference between the two limbs already at baseline, which became significant at 7 days showing a 14.8% reduction in PA and a 0.6 mm decrease in MT in the VL of the affected limb. In the unaffected limb, PA decreased by 13.6% and MT by 0.5 mm. Conclusions Ultrasound assessment may be a useful tool for early evaluation of muscle changes and sarcopenia in stroke patients. These preliminary findings warrant further investigation in larger cohorts to assess clinical relevance and implications for rehabilitation strategies. Conflict of interest For all authors nothing to disclose