Hyperdense Artery Sign, Clot Characteristics, and Response to Intravenous Thrombolysis in Han Chinese People with Acute Large Arterial Infarction

Background: Whether the presence of hyperdense artery sign (HAS) correlates with clot characteristics and response to intravenous thrombotic therapy (IVT) remains to be determined. Given that the existent literature was mainly from the Western nations, the current study aimed to examine the relationships among HAS, clot characteristics, and outcome of IVT in a Han Chinese sample in Taiwan. The specific objectives are (1) to correlate HAS with clot characteristics and (2) to explore relationships between HAS and effectiveness/complication of IVT.

Methods: We enrolled 75 patients treated with IVT following acute large arterial infarctions. All patients had a baseline brain computed tomography and a follow-up image at 24 hours after thrombolysis. Correlations were explored between HAS and clot characteristics. Multivariable logistic regressions were employed to examine the relationships between HAS and response to IVT at 24 hours, including early improvement and all forms of intracerebral hemorrhage (ICH).

Results: In this Han Chinese sample in Taiwan, 50.7% of the patients had HAS and 64% had early improvements following IVT. Those with HAS tended to have clots lodging at main trunks of cerebral arteries but no significant associations were found between HAS and stroke etiology. In multivariable logistic regressions, HAS predicted neither early improvement nor ICH complication.

Conclusions: Instead of clot etiology, we found that it might be clot location that correlated with HAS. HAS was not associated with early improvement or ICH complication after IVT in this Han Chinese sample. We also showed that some other patient characteristics were likely to influence outcomes of IVT, which warrant clinical attention.