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Ninety-two consecutive patients with a known (n = 24) or suspected arteriovenous shunting (n = 68) underwent DSA and brain MR imaging, including arterial spin-labeling/SWI and conventional angiographic MR imaging. DSA showed arteriovenous shunting in 63 of the 92 patients. Interobserver agreement was excellent. In 5 patients, arterial spin-labeling/SWI correctly detected arteriovenous shunting, while the conventional angiographic MR imaging did not. The authors conclude that the combined use of arterial spin-labeling and SWI may be an alternative to contrast-enhanced MRA for the detection of intracranial arteriovenous shunting.

The authors reviewed the impact of revascularization on clinical outcomes in 83 patients with M2 occlusions in the Interventional Management of Stroke III trial according to specific M1–M2 segment anatomic features. AnmRS 0–2 outcome was associated with reperfusion for M2 trunk (n = 9) or M2 division (n = 42) occlusions, but not for M2 branch occlusions (n = 28). Of the 83 participants with M2 occlusion who underwent endovascular therapy, 41.0% achieved mRS 0–2 at 90 days, including 46.6% with modified TICI 2–3 reperfusion compared with 26.1% with modified TICI 0–1 reperfusion. They conclude that mRS 0–2 at 90 days was dependent on reperfusion for M2 trunk but not for M2 branch occlusions in IMS III.