Appearance of Early Venous Filling During Intra-Arterial Reperfusion Therapy for Acute Middle Cerebral Artery Occlusion A Predictive Sign for Hemorrhagic Complications

Background and Purpose— The purpose of this study was to evaluate the correlation between appearance of angiographic early venous fillingduring intra-arterial reperfusion therapyand posttherapeutic hemorrhagic complications. Methods— For the past 7 years, 104 patients prospectively underwent superselectivelocal angiography via a microcatheter before and during intra-arterial reperfusion therapyfor acute middle cerebral arteryocclusion to evaluate the presence or absence of early venous filling. In principle, reperfusion therapywas discontinued just after appearance of early venous fillingfor fear of hemorrhage. There were 2 types of early venous filling: early fillingof the thalamostriate vein from the lenticulostriate arteriesand that of the cortical vein from the cortical arteries. Results— Among these 104 patients, 31 (29.8%) had early venous filling: 19 had early fillingof the thalamostriate vein, and the other 12 had early fillingof the cortical vein. Eight of the 19 patients (42.1%) and 2...