Impact of cerebral small vessel disease on ischemic stroke progression

Francesco Arba, MD, PhD, FESO, Careggi University Hospital, Florence, Italy, talks on the implications of cerebral small vessel disease (SVD) markers in patients with acute ischemic stroke treated with intravenous thrombolysis (IVT). Given the high prevalence of SVD pathology in older adults, the study aimed to determine the consequences of SVD on the evolution of ischemic brain tissue. A total of 165 patients were included, who underwent assessment of SVD markers, ischemic core volume, and final infarct volume. The presence of SVD markers was associated with smaller infarct growth, despite similar final infarct volumes, compared to those without SVD features, suggesting less salvageable tissue was present at the time of treatment. While SVD markers are known to contribute to worse outcomes with thrombolysis, Dr Arba notes that they should not be considered a contraindication. This interview took place at the ESOC 2022 congress in Lyon, France.