Table 3 Considerations regarding the potential cause of INT/IINHT.
From: Infarct in new territory after endovascular stroke treatment: A diffusion-weighted imaging study
Arguments in favor of being related to the procedure | Arguments against being related to the procedure |
|---|---|
If the index event is caused by an unstable thrombus or plaque, which causes subsequent infarction to other territories, patients with several emboli or multiple occlusions on admission should be more likely to develop INT/IINHT. | Ganesh et al. found a comparable frequency of INT in patients treated with IV tPA alone and those additionally treated with mechanical thrombectomy3. |
If INT are unrelated to the procedure, they can be expected to occur randomly in intracranial territories. However, the percental occurrence of type A manipulation types was close to 50%, thus clearly over-representing territories with a close proximity to the occlusion site and where catheter manipulation took place. | INT also occurred in patients receiving only diagnostic angiography and thus not all infarcts can be associated with the interventional part of angiography (although occurrence due to diagnostic angiography is possible). |
Theoretically, a prolonged time interval between the endovascular procedure and follow-up MRI should extend the period during which INT unrelated to the procedure could occur. However, no such association was noted. |
