Abstract A032: Pragmatic Transcranial Doppler Metrics Predict Parenchymal Hemorrhage Following Successful Endovascular Thrombectomy in Anterior Large Vessel Occlusion Stroke

Introduction: Parenchymal hemorrhage (PH) remains a significant complication following successful endovascular thrombectomy (EVT). We aimed to define bedside transcranial doppler (TCD) measures associated with PH. Method: We reviewed 162 patients with MCA-M1 or ICA terminus occlusion who underwent successful recanalization (TICI≥2b) and TCD within 24-72 hours post EVT. MCA mean flow velocity (MFV), peak-systolic velocity (PSV), end-diastolic velocity (EDV), and pulsatility index (PI) were measured in the ipsilateral (EVT) and contralateral (control) sides. EVT-to-control side ratios (MFV-R, PSV-R, EDV-R and PI-R) were calculated. Dynamic Flow Index (DFI), defined as MFV ÷ PI, was used to explore microvascular conductance as previously validated. PH was classified as