ArticleNeurology2021
Association of CT-Based Hypoperfusion Index With Ischemic Core Enlargement in Patients With Medium and Large Vessel Stroke.
Article in Neurology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 12 citations in OpenAlex.
- Thrombectomy for Acute Stroke Due to Medium Vessel Occlusion Across Perfusion Mismatch Profiles: A Post Hoc Analysis of the ESCAPE-MeVO Trial.JAMA network open · 2026Trial
- Target mismatch criteria in acute ischemic stroke patients with distal-medium vessel occlusion.European stroke journal · 2026Article
- Adjusting input arterial function to improve the accuracy of hypoperfusion assessment in computed tomography perfusion (CTP) for stroke: a preliminary study.Quantitative imaging in medicine and surgery · 2025Article
- Target mismatch criteria in acute ischemic stroke patients with distal-medium vessel occlusion.European stroke journal · 2025Article
- Association of CT perfusion parameters with outcomes in patients with medium vessel occlusion undergoing endovascular thrombectomy.Therapeutic advances in neurological disorders · 2025Article
- 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
- Development of machine learning models for predicting outcome in patients with distal medium vessel occlusions: a retrospective study.Quantitative imaging in medicine and surgery · 2023Article
- Collateral Circulation in Ischemic Stroke: An Updated Review.Journal of stroke · 2023Review
- Quantitative assessment of collateral time on perfusion computed tomography in acute ischemic stroke patients.Frontiers in neurology · 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
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Authors and funding
9 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
objectivesThe rate of infarct core progression in patients with acute ischemic stroke is variable and affects outcome of reperfusion therapy. We evaluated the hypoperfusion index (HI) to estimate the initial rate of core progression in patients with medium vessel occlusion (MeVO) compared to large vessel occlusion (LVO) stroke and within a larger time frame since stroke onset.
methodsCore progression was assessed in 106 patients with acute stroke and CT perfusion. Using reperfusion trial core time criteria, fast progressors had core >70 mL within 6 hours of stroke onset and slow progressors had core ≤70 mL, mismatch ≥15 mL, and mismatch to core ratio ≥1.8 within 6 to 24 hours. The relationship between HI and infarct core progression (core/time) was examined using receiver operating characteristics to determine optimal HI cutoff. The HI cutoff was then tested in the overall cohort, compared between MeVO and LVO, and evaluated in patients up to 24 hours from stroke onset to differentiate fast from slow rate of core progression. HI threshold was assessed in a second independent cohort of 110 patients with acute ischemic stroke.
resultsIn 106 patients with acute stroke, 6.6% were fast progressors, 27.4% were slow progressors, and 66% were not classified as fast or slow progressor by reperfusion trial core time criteria. HI >0.5 was associated with fast progression and able to distinguish fast from slow progressors (area under the curve [AUC] 0.94; 95% confidence interval [CI] 0.80-0.99). In MeVO (n = 26) HI >0.5 had a core progression of 0.30 mL/min compared to 0.03 mL/min for HI ≤0.5 ( DISCUSSION: HI can differentiate fast from slow core progression in MeVO and LVO within the first 24 hours of acute ischemic stroke. Consideration of core progression rate at time of stroke evaluation may have implications in the selection of patients with MeVO and LVO stroke for reperfusion therapy that warrant further study.
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