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Peer-reviewedCC BYTranslational stroke research

Long-Term Quantitative MRI and Quality-of-Life After Endovascular Therapy in Acute Ischemic Stroke - A MR CLEAN-NO IV Substudy.

  • Praneeta R Konduri1
  • Dimitrios Karkalousos1
  • Alexandra de Sitter2
  • Manon Kappelhof2
  • Maarten M H Lahr3
  • Chi P Nguyen3
  • Aad van der Lugt4
  • Yvo B Roos5
  • Jonathan M Coutinho5
  • Henk A Marquering1,2
  • Charles B L M Majoie2
  • Bart J Emmer2
2 more authors
  • Luka C Liebrand1
  • Matthan W A Caan6
6 affiliations
  1. 1Department of Biomedical Engineering and Physics, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands.
  2. 2Department of Radiology and Nuclear Medicine, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands.
  3. 3Department of Epidemiology, Health Technology Assessment unit, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
  4. 4Department of Radiology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands.
  5. 5Department of Neurology, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands.
  6. 6Department of Biomedical Engineering and Physics, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands. [email protected].
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Abstract

This study aims to explore the long-term evolution of endovascular treatment after acute ischemic stroke (AIS) using quantitative MRI, and its relationship with quality of life (QoL). In this long-term substudy of patients from the MR CLEAN-NO IV trial, patients were included who received 24-hour post-stroke MRI and were functionally independent 90 days after stroke onset. Patients underwent a quantitative MRI exam three years after stroke onset to measure focal volume loss, myelin damage, iron deposition, and atrophy within and around the ischemic lesion seen on 24-hour-MRI, in addition to a QoL assessment. Bayesian statistical analyses were used to assess MRI measures lateralized to the ipsilateral hemisphere and to evaluate the relationship of these measures with baseline and treatment characteristics along with QoL. The Bayes Factor (BF) reflected moderate, strong or very strong evidence (BF = 3.0;20;1.5⋅10² respectively). In the 24 included patients, prominent focal volume loss, iron deposition, ventricular enlargement and myelin damage (BF:2.0⋅10²) were observed peripheral to the initial 24-hour DWI lesion at long-term FU MRI. In the basal ganglia nuclei, very strong evidence of focal volume loss (BF > 8.1⋅10²) and moderate to very strong evidence of iron deposition (BF: 5.0 to 2.7⋅10²) were observed at long-term assessment. Higher systolic blood pressure was associated with reduced long-term ventricular atrophy (BF:5.8). Long-term differences in ipsilateral versus contralateral hippocampal volume difference (BF:8.0) and iron deposition (BF:4.1) were moderately associated with QoL. Long-term subtle yet widespread demyelination and iron deposition were observed, and these changes correlated with long-term recovery.

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Cite

BibTeXRIS
BibTeX
@article{konduri2026longterm,
  title = {{Long-Term Quantitative MRI and Quality-of-Life After Endovascular Therapy in Acute Ischemic Stroke - A MR CLEAN-NO IV Substudy.}},
  author = {Praneeta R Konduri and Dimitrios Karkalousos and Alexandra de Sitter and Manon Kappelhof and Maarten M H Lahr and Chi P Nguyen and Aad van der Lugt and Yvo B Roos and Jonathan M Coutinho and Henk A Marquering and Charles B L M Majoie and Bart J Emmer and Luka C Liebrand and Matthan W A Caan},
  journal = {Translational stroke research},
  year = {2026},
  month = oct,
  doi = {10.1007/s12975-026-01497-8},
  url = {https://europepmc.org/article/MED/42864556},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Long-Term Quantitative MRI and Quality-of-Life After Endovascular Therapy in Acute Ischemic Stroke - A MR CLEAN-NO IV Substudy.
AU  - Praneeta R Konduri
AU  - Dimitrios Karkalousos
AU  - Alexandra de Sitter
AU  - Manon Kappelhof
AU  - Maarten M H Lahr
AU  - Chi P Nguyen
AU  - Aad van der Lugt
AU  - Yvo B Roos
AU  - Jonathan M Coutinho
AU  - Henk A Marquering
AU  - Charles B L M Majoie
AU  - Bart J Emmer
AU  - Luka C Liebrand
AU  - Matthan W A Caan
PY  - 2026
DA  - 2026/10/13
JO  - Translational stroke research
DO  - 10.1007/s12975-026-01497-8
UR  - https://europepmc.org/article/MED/42864556
AB  - This study aims to explore the long-term evolution of endovascular treatment after acute ischemic stroke (AIS) using quantitative MRI, and its relationship with quality of life (QoL). In this long-term substudy of patients from the MR CLEAN-NO IV trial, patients were included who received 24-hour post-stroke MRI and were functionally independent 90 days after stroke onset. Patients underwent a quantitative MRI exam three years after stroke onset to measure focal volume loss, myelin damage, iron deposition, and atrophy within and around the ischemic lesion seen on 24-hour-MRI, in addition to a QoL assessment. Bayesian statistical analyses were used to assess MRI measures lateralized to the ipsilateral hemisphere and to evaluate the relationship of these measures with baseline and treatment characteristics along with QoL. The Bayes Factor (BF) reflected moderate, strong or very strong evidence (BF = 3.0;20;1.5⋅10² respectively). In the 24 included patients, prominent focal volume loss, iron deposition, ventricular enlargement and myelin damage (BF:2.0⋅10²) were observed peripheral to the initial 24-hour DWI lesion at long-term FU MRI. In the basal ganglia nuclei, very strong evidence of focal volume loss (BF > 8.1⋅10²) and moderate to very strong evidence of iron deposition (BF: 5.0 to 2.7⋅10²) were observed at long-term assessment. Higher systolic blood pressure was associated with reduced long-term ventricular atrophy (BF:5.8). Long-term differences in ipsilateral versus contralateral hippocampal volume difference (BF:8.0) and iron deposition (BF:4.1) were moderately associated with QoL. Long-term subtle yet widespread demyelination and iron deposition were observed, and these changes correlated with long-term recovery.
SN  - 1868-4483
SN  - 1868-601X
ER  -