ABSTRACT NUMBER: ESOC2026A1186 ASSOCIATION BETWEEN POST-INTERVENTION MRI PARAMETERS AND CLINICAL OUTCOMES AFTER ENDOVASCULAR THROMBECTOMY FOR ACUTE ISCHEMIC STROKE OF THE ANTERIOR CIRCULATION: A SYSTEMATIC REVIEW AND META-ANALYSIS

Abstract Background and aims For patients with acute ischemic stroke treated with endovascular thrombectomy (EVT), the translation of neuroprotective treatment strategies from the laboratory to the clinic has remained disappointing. MRI-based infarct characteristics may offer a solution to improve statistical power of phase II trials, but the associations between the diverse MRI measures reported and functional outcomes vary across studies. Methods We conducted a systematic literature review to evaluate the association between post-procedural MRI parameters and functional outcome in patients with ischemic stroke caused by a proximal anterior circulation occlusion treated with EVT. If the included studies are sufficiently homogeneous, a random-effects meta-analysis will be performed using pooled effect estimates. Otherwise, findings will be synthesized narratively. Results We included 85 studies that reported both MRI findings and functional outcomes after EVT. The most frequently reported MRI measures were infarct volume (n = 23) and infarct evolution (growth or reduction, n = 20 and n = 11, respectively). Perfusion abnormalities, infarct topology, blood–brain barrier disruption, hemorrhagic and susceptibility-based markers, measures of structural or functional connectivity, hemodynamic changes, MRA, peripheral emboli, and oxygen extraction fraction were assessed in 13, 8, 7, 7, 6, 4, 3, 2 and 1 studies, respectively. There was substantial variation in imaging timing, imaging protocols, and the definitions used for clinical outcomes across studies. Conclusions Heterogeneity across studies complicates analysis of the relationship between MRI measures and functional outcomes after EVT. Quantitative analyses of the associations between MRI variables and functional outcomes are ongoing. These results and recommendations will be presented. Conflict of interest Quinty Omes: nothing to disclose. Victor Geraedts: nothing to disclose. Bart van der Worp: nothing to disclose. Jeannette Hofmeijer: nothing to disclose. Ido van den Wijngaard: nothing to disclose.