ArticleInternational journal of stroke : official journal of the International Stroke Society2022
Brain atrophy and endovascular treatment effect in acute ischemic stroke: a secondary analysis of the MR CLEAN trial.
Article in International journal of stroke : official journal of the International Stroke Society, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed, 18 citations in OpenAlex.
- Association of Brain Atrophy With Functional Outcome and Recovery Trajectories After Thrombectomy: Post Hoc Analysis of the ESCAPE-NA1 Trial.Neurology · 2023Trial
- A CT imaging-based prediction model of functional outcome and benefit of endovascular thrombectomy for ischemic stroke.European radiology · 2026Article
- Diaschisis as Cerebello-Cortical Loop Dysfunction in Acute Ischemic Stroke: A Network Framework for Outcome Variability.Brain sciences · 2026Review
- Reperfusion stroke injury and brain atrophy: a penumbra of progressive cognitive decline.Annals of medicine and surgery (2012) · 2025Article
- Reversibility of diffuse magnetic resonance imaging following endovascular therapy in acute ischemic stroke: a systematic review and meta-analysis.Quantitative imaging in medicine and surgery · 2025Article
- Brain Atrophy Is Associated with Hematoma Expansion in Intracerebral Hemorrhage, Depending on Coagulation Status.Journal of clinical medicine · 2025Article
- Automated brain atrophy quantification from clinical MRI predicts early neurological deterioration in anterior choroidal artery territory infarction.Frontiers in neuroscience · 2025Article
- Predictors of futile recanalization in ischemic stroke patients with low baseline NIHSS.International journal of stroke : official journal of the International Stroke Society · 2024Article
- Impact of Intracranial Volume and Brain Volume on the Prognostic Value of Computed Tomography Perfusion Core Volume in Acute Ischemic Stroke.Journal of cardiovascular development and disease · 2024Article
- Cortical atrophy on baseline computed tomography imaging predicts clinical outcome in patients undergoing endovascular treatment for acute ischemic stroke.European radiology · 2024Article
- Brain volume is a better biomarker of outcomes in ischemic stroke compared to brain atrophy.Frontiers in stroke · 2024Article
- Cortical and Subcortical Brain Atrophy Assessment Using Simple Measures on NCCT Compared with MRI in Acute Stroke.AJNR. American journal of neuroradiology · 2023Article
- Cerebral Small Vessel Disease and Outcomes in Patients With Acute Ischemic Stroke Receiving Endovascular Treatment: A Systematic Review and Meta-Analysis.Stroke (Hoboken, N.J.) · 2023Article
- Fully Automatic Classification of Brain Atrophy on NCCT Images in Cerebral Small Vessel Disease: A Pilot Study Using Deep Learning Models.Frontiers in neurology · 2022Article
- Utilizing Quantitative Analysis of CSF Volume from Clinical T1-Weighted MRI to Predict Thrombectomy Outcomes.Journal of neuroimaging : official journal of the American Society of NeuroimagingArticle
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Authors and funding
11 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundBrain atrophy is suggested to impair the potential for functional recovery after acute ischemic stroke. We assessed whether the effect of endovascular treatment is modified by brain atrophy in patients with acute ischemic stroke due to large vessel occlusion.
methodsWe used data from MR CLEAN, a multicenter trial including patients with acute ischemic stroke due to anterior circulation large vessel occlusion randomized to endovascular treatment plus medical care (intervention) versus medical care alone (control). We segmented total brain volume (TBV) and intracranial volume (ICV) on baseline non-contrast computed tomography (n = 410). Next, we determined the degree of atrophy as the proportion of brain volume in relation to head size (1 - TBV/ICV) × 100%, analyzed as continuous variable and in tertiles. The primary outcome was a shift towards better functional outcome on the modified Rankin Scale expressed as adjusted common odds ratio. Treatment effect modification was tested using an interaction term between brain atrophy (as continuous variable) and treatment allocation.
resultsWe found that brain atrophy significantly modified the effect of endovascular treatment on functional outcome (P for interaction = 0.04). Endovascular treatment led to larger shifts towards better functional outcome in the higher compared to the lower range of atrophy (adjusted common odds ratio, 1.86 [95% CI: 0.97-3.56] in the lowest tertile vs. 1.97 [95% CI: 1.03-3.74] in the middle tertile vs. 3.15 [95% CI: 1.59-6.24] in the highest tertile).
conclusionBenefit of endovascular treatment is larger in the higher compared to the lower range of atrophy, demonstrating that advanced atrophy should not be used as an argument to withhold endovascular treatment.
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