ArticleJournal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism2021
Normative distribution of posterior circulation tissue time-to-maximum: Effects of anatomic variation, tracer kinetics, and implications for patient selection in posterior circulation ischemic stroke.
Article in Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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16 citing papers in PubMed, 25 citations in OpenAlex.
- Computed Tomography-Based Imaging Scores in Basilar Artery Occlusions: A Comparison of Predictive Abilities for Functional Outcomes.Stroke (Hoboken, N.J.) · 2026Article
- Competitive blood flow from the contralateral vertebral artery signifies a favorable outcome after successful recanalization for acute posterior circulation ischemic stroke.European radiology · 2026Article
- Predictors of devastating functional outcome despite successful basilar thrombectomy.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2026Article
- Conventional versus advanced imaging selection for endovascular treatment of basilar artery occlusion strokes.European stroke journal · 2026Article
- Endovascular Revascularization for Chronic Vertebral Artery Occlusion with Poor Collateral Circulation and a Large Perfusion Abnormality Identified by Automated Perfusion Imaging: A Case Report.Journal of neuroendovascular therapy · 2026Article
- Endovascular Therapy for Acute Basilar Artery Occlusion: Prognosis Prediction Value from Clinical to Imaging Variables.Revista de neurologia · 2025Article
- Conventional versus advanced imaging selection for endovascular treatment of basilar artery occlusion strokes.European stroke journal · 2025Article
- Perfusion imaging parameters predict long-term clinical outcome in isolated posterior cerebral artery occlusion stroke patients.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2025Article
- Computed tomography perfusion-defined ischemic core predicts functional outcome after basilar artery thrombectomy.Frontiers in neurology · 2025Article
- CT perfusion imaging in aneurysmal subarachnoid hemorrhage. State of the art.Frontiers in radiology · 2024Review
- Posterior circulation cerebral infarction: A review of clinical, imaging features, management, and outcomes.European journal of radiology open · 2023Article
- Basilar artery occlusion: A review of clinicoradiologic features, treatment selection, and endovascular techniques.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2023Review
- Imaging Factors Associated With Poor Outcome in Patients With Basilar Artery Occlusion Treated With Endovascular Thrombectomy.Stroke (Hoboken, N.J.) · 2023Article
- Reproducibility of cerebral perfusion measurements using BOLD delay.Human brain mapping · 2023Article
- Predictors of hyperperfusion syndrome after stent implantation in symptomatic intracranial atherosclerotic stenosis.Quantitative imaging in medicine and surgery · 2023Article
- Automated Supra- and Infratentorial Brain Infarct Volume Estimation on Diffusion Weighted Imaging Using the RAPID Software.Frontiers in neurology · 2022Article
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Authors and funding
4 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The generalization of perfusion-based, anterior circulation large vessel occlusion selection criteria to posterior circulation stroke is not straightforward due to physiologic delay, which we posit produces physiologic prolongation of the posterior circulation perfusion time-to-maximum (Tmax). To assess normative Tmax distributions, patients undergoing CTA/CTP for suspected ischemic stroke between 1/2018-3/2019 were retrospectively identified. Subjects with any cerebrovascular stenoses, or with follow-up MRI or final clinical diagnosis of stroke were excluded. Posterior circulation anatomic variations were identified. CTP were processed in RAPID and segmented in a custom pipeline permitting manually-enforced arterial input function (AIF) and perfusion estimations constrained to pre-specified vascular territories. Seventy-one subjects (mean 64 ± 19 years) met inclusion. Median Tmax was significantly greater in the cerebellar hemispheres (right: 3.0 s, left: 2.9 s) and PCA territories (right: 2.9 s; left: 3.3 s) than in the anterior circulation (right: 2.4 s; left: 2.3 s, p < 0.001). Fetal PCA disposition eliminated ipsilateral PCA Tmax delays (p = 0.012). Median territorial Tmax was significantly lower with basilar versus any anterior circulation AIF for all vascular territories (p < 0.001). Significant baseline delays in posterior circulation Tmax are observed even without steno-occlusive disease and vary with anatomic variation and AIF selection. The potential for overestimation of at-risk volumes in the posterior circulation merits caution in future trials.
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