ArticleEuropean radiology2019
Benefit from revascularization after thrombectomy according to FLAIR vascular hyperintensities-DWI mismatch.
Article in European radiology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 2 of them syntheses that pooled it.
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Who cites it
17 citing papers in PubMed, 2 syntheses or guidelines pooled it, 34 citations in OpenAlex.
- FLAIR vascular hyperintensity is associated with functional outcome in patients with ischemic stroke receiving endovascular treatment: a meta-analysis.Frontiers in neurology · 2024Pooled it
- MRI for collateral assessment pre-thrombectomy and association with outcome: a systematic review and meta-analysis.Neuroradiology · 2023Pooled it
- Correlation of fluid-attenuated inversion recovery sequence vascular hyperintensity in magnetic resonance with collateral circulation and short-term clinical prognosis in acute ischemic stroke.Quantitative imaging in medicine and surgery · 2024Article
- Estimating the volume of penumbra in rodents using DTI and stack-based ensemble machine learning framework.European radiology experimental · 2024Article
- Fluid-attenuated inversion recovery vascular hyperintensity-diffusion-weighted imaging mismatch and functional outcome after endovascular reperfusion therapy for acute ischemic stroke.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2024Article
- Comparison between MRI FLAIR vascular hyperintensity-DWI mismatch and perfusion based triage for thrombectomy in the late time window.Frontiers in neurology · 2024Article
- Ultrafast MRI using deep learning echoplanar imaging for a comprehensive assessment of acute ischemic stroke.European radiology · 2023Article
- Association of fluid-attenuated inversion recovery vascular hyperintensity with ischaemic events in internal carotid artery or middle cerebral artery occlusion.Stroke and vascular neurology · 2023Article
- FLAIR Vascular Hyperintensities as a Surrogate of Collaterals in Acute Stroke: DWI Matters.AJNR. American journal of neuroradiology · 2023Article
- Prognostic value of post-treatment fluid-attenuated inversion recovery vascular hyperintensity in ischemic stroke after endovascular thrombectomy.European radiology · 2022Article
- Article
- Preprocedural Imaging : A Review of Different Radiological Factors Affecting the Outcome of Thrombectomy.Clinical neuroradiology · 2022Review
- Hemodynamics derived from computational fluid dynamics based on magnetic resonance angiography is associated with functional outcomes in atherosclerotic middle cerebral artery stenosis.Quantitative imaging in medicine and surgery · 2022Article
- Wake-up stroke: imaging-based diagnosis and recanalization therapy.Journal of neurology · 2021Review
- FLAIR vascular hyperintensities and functional outcome in nonagenarians with anterior circulation large-vessel ischemic stroke treated with endovascular thrombectomy.European radiology · 2021Article
- The impact of FLAIR vascular hyperintensity on clinical severity and outcome : A retrospective study in stroke patients with proximal middle cerebral artery stenosis or occlusion.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2021Article
- Fluid-Attenuated Inversion Recovery Vascular Hyperintensity in Cerebrovascular Disease: A Review for Radiologists and Clinicians.Frontiers in aging neuroscience · 2021Review
Corrections and comments
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Authors and funding
16 authors at 6 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesWe tested whether FLAIR vascular hyperintensities (FVH)-DWI mismatch could identify candidates for thrombectomy most likely to benefit from revascularization.
methodsWe retrospectively reviewed 100 patients with proximal MCA occlusion from 18 stroke centers randomized in the IV-thrombolysis plus mechanical thrombectomy arm of the THRACE trial (2010-2015). We tested the associations between successful revascularization on digital subtraction angiography (modified Thrombolysis in Cerebral Infarction 2b/3) and 3-month favorable outcome (modified Rankin Scale score ≤ 2), stratified on FVH-DWI mismatch status, with secondary analyses adjusted on National Institutes of Health Stroke Scale (NIHSS) and DWI lesion volume.
resultsFVH-DWI mismatch was present in 79% of patients, with a similar prevalence at 1.5 T (80%) and 3 T (78%). Successful revascularization (74%) was more frequent in patients with FVH-DWI mismatch (63/79, 80%) than in patients without (11/21, 52%), p = 0.01. The OR of favorable outcome for revascularization were 15.05 (95% CI 3.12-72.61, p < 0.001) in patients with FVH-DWI mismatch and 0.83 (95% CI 0.15-4.64, p = 0.84) in patients without FVH-DWI mismatch (p = 0.011 for interaction). Similar results were observed after adjustment for NIHSS (OR = 12.73 [95% CI 2.69-60.41, p = 0.001] and 0.96 [95% CI 0.15-6.30, p = 0.96]) or for DWI volume (OR = 12.37 [95% CI 2.76-55.44, p = 0.001] and 0.91 [95% CI 0.16-5.33, p = 0.92]) in patients with and without FVH-DWI mismatch, respectively.
conclusionsThe FVH-DWI mismatch identifies patients likeliest to benefit from revascularization, irrespective of initial DWI lesion volume and clinical stroke severity, and could serve as a useful surrogate marker for penumbral evaluation. KEY POINTS: • The FVH-DWI mismatch, defined by FLAIR vascular hyperintensities (FVH) located beyond the boundaries of the DWI lesion, is associated with large penumbra. • Among stroke patients with proximal middle cerebral artery occlusion referred for thrombectomy, those with FVH-DWI mismatch are most likely to benefit from revascularization. • FVH-DWI mismatch provides an alternative to PWI-DWI mismatch in order to select patients who are candidates for thrombectomy.
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