Cerebralarterialairembolionimmediatepost-endovasculartreatmentCTareassociatedwithpoorshortandlong-

PurposeTodeterminetheincidenceandpredictorsofcerebralarterialairemboli(CAAE) onimmediatepostendovasculartreatment(EVT) dual-energyCT(DECT) inacuteischaemicstroke(AIS) patients, anddescribetheirassociationwithclinicaloutcomes. Methods: EVTrecordsfrom2010to2019werescreened. Exclusioncriteriaincludedintracerebralhaemorrhageonpost-EVTDECT. Intheaffectedmiddlecerebralartery(MCA)-territory, circularandlinear(length >= 1.5*width) CAAEwerecounted. Clinicaldatawerecollectedfromprospectiverecords. ThemodifiedRankinScale( mRS) at90dayswastheprimaryoutcome. Multivariablelinear, logistic, andordinalregressionwereusedtoanalysetheeffectof( 1) linearCAAEand(2) isolatedcircularCAAE. Results: Outof651EVT-records, 402patientswereincluded. In65patients(16%), atleastonelinearCAAEwasfoundintheaffectedMCAterritory. 17patients(4%) showedisolatedcircularCAAE. MultivariableregressionshowedanassociationbetweenboththepresenceandthenumberoflinearCAAEandthemRSat90days( presence: adjusted(a)cOR3.10,95%CI1.75-5.50; number: acOR1.28,95%CI1.13-1.44), NIHSSat2448h(presence: ab4.15,95%CI1.87-6.43; number: ab0.88,95%CI0.42-1.34), mortalityat90days(presence: aOR3.34,95%CI1.51-7.40; number: aOR1.24,95%CI1.08-1.43) andstrokeprogression(presence: aOR4.01,95%CI1.96-8.18; number: aOR1.31,95%CI1.15-1.50). IsolatedcircularCAAEwerenotsignificantlyassociatedwithanyoutcomemeasure. Conclusion: CAAEwerefoundfrequentlyonpost-EVTCTimaging. ThepresenceandthenumberoflinearCAAE, butnotcircularCAAE, areassociatedwithunfavourableshort- andlong-termclinicaloutcomes. (c) 2023TheAuthors. PublishedbyElsevierMassonSAS. ThisisanopenaccessarticleundertheCCBYlicense(

Automated summary

This study investigated the incidence and predictors of cerebral arterial air emboli (CAAE) on immediate post endovascular treatment (EVT) dual-energy CT (DECT) in acute ischemic stroke (AIS) patients, and described their association with clinical outcomes. The presence and number of linear CAAE, but not circular CAAE, were found to be associated with unfavorable short- and long-term clinical outcomes.