ArticleNeurocritical care2021
Hypoperfusion Intensity Ratio Predicts Malignant Edema and Functional Outcome in Large-Vessel Occlusive Stroke with Poor Revascularization.
Article in Neurocritical care, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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Who cites it
18 citing papers in PubMed, 29 citations in OpenAlex.
- Sequential NIHSS-NLR monitoring after endovascular thrombectomy: malignant cerebral oedema and inflammatory futility in a two-phase derivation study.Frontiers in neurology · 2026Article
- A prognostic model for early risk stratification in adult community-acquired suspected CNS infections: multicenter development and external validation.BMC infectious diseases · 2025Article
- Role of Hypoperfusion Intensity Ratio in Vessel Occlusions: A Review on Safety and Clinical Outcomes.AJNR. American journal of neuroradiology · 2025Review
- The Cortical Vein Opacification Score (COVES) Is Independently Associated with DSA ASITN Collateral Score.AJNR. American journal of neuroradiology · 2025Article
- Association of critical hypoperfusion biomarkers on CT with futile recanalization and poor outcome after mechanical thrombectomy in acute ischemic stroke.BMC neurology · 2024Article
- Hypoperfusion Intensity Ratio Is Associated with Early Neurologic Deficit Severity and Deterioration after Mechanical Thrombectomy in Large-Vessel Occlusion Ischemic Stroke.AJNR. American journal of neuroradiology · 2024Article
- Imaging in acute ischaemic stroke: assessing findings in light of evolving therapies.The British journal of radiology · 2024Review
- A dynamic nomogram for predict individual risk of malignant brain edema after endovascular thrombectomy in acute ischemic stroke.Scientific reports · 2024Article
- Collateral Status, Reperfusion, and Cerebral Edema After Thrombectomy for Stroke.Neurocritical care · 2024Article
- Association Between Hypoperfusion Intensity Ratio and Postthrombectomy Malignant Brain Edema for Acute Ischemic Stroke.Neurocritical care · 2024Article
- The Compensation Index Is Better Associated with DSA ASITN Collateral Score Compared to the Cerebral Blood Volume Index and Hypoperfusion Intensity Ratio.Journal of clinical medicine · 2023Article
- Elevated Hypoperfusion Intensity Ratio (HIR) observed in patients with a large vessel occlusion (LVO) presenting in the evening.Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association · 2023Observational
- Collateral Flow: Prolonging the Ischemic Penumbra.Translational stroke research · 2023Article
- Correlation between Hypoperfusion Intensity Ratio and Functional Outcome in Large-Vessel Occlusion Acute Ischemic Stroke: Comparison with Multi-Phase CT Angiography.Journal of clinical medicine · 2022Article
- Prognostic Accuracy of CTP Summary Maps in Patients with Large Vessel Occlusive Stroke and Poor Revascularization after Mechanical Thrombectomy-Comparison of Three Automated Perfusion Software Applications.Tomography (Ann Arbor, Mich.) · 2022Article
- Predictors and Dynamic Nomogram to Determine the Individual Risk of Malignant Brain Edema After Endovascular Thrombectomy in Acute Ischemic Stroke.Journal of clinical neurology (Seoul, Korea) · 2022Article
- Predicting futile recanalization, malignant cerebral edema, and cerebral herniation using intelligible ensemble machine learning following mechanical thrombectomy for acute ischemic stroke.Frontiers in neurology · 2022Article
- Pre-stroke Physical Activity and Cerebral Collateral Circulation in Ischemic Stroke: A Potential Therapeutic Relationship?Frontiers in neurology · 2022Article
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
objectiveMalignant cerebral edema (MCE) is a well-known complication in patients with acute ischemic stroke with core infarcts ≥ 80 mL caused by large-vessel occlusions. MCE can also develop in patients with smaller infarcts with moderate -to-large volume of tissue at risk who do not achieve successful revascularization with endovascular thrombectomy (ET). Features that predict the development of MCE in this population are not well-described. We aim to identify predictors of MCE and 90-day functional outcome in stroke patients with an anterior circulation large vessel occlusion (LVO) and a < 80 mL ischemic core who do not achieve complete reperfusion.
methodsWe reviewed our institutional stroke registry and included patients who achieved unsuccessful revascularization, mTICI 0-2a, after ET and whose baseline imaging was notable for a core infarct < 80 mL, a T
resultsThirty-six patients met inclusion criteria. Unadjusted analysis demonstrated that younger age, higher systolic blood pressure, larger core volume, and higher hypoperfusion intensity ratio (HIR) were associated with MCE (all p < 0.02). In multivariate logistic regression analysis, age, HIR, and core infarct volume were independent predictors of MCE. The optimal HIR threshold to predict MCE was ≥ 0.54 (OR 14.7, 95% CI 2.4-78.0, p = 0.003). HIR was also associated with 3-month mRS (HIR ≥ 0.54 for mRS of 3-6: OR 10.8, 95% CI 1.9-44.0, p = 0.02).
conclusionsYounger age, larger core infarct volume, and higher HIR are predictive of MCE in patients with anterior circulation LVO, moderate-to-large tissue at risk, and suboptimal revascularization. HIR is correlated with three-month functional outcomes.
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