Evidence map›Paper›PMID 34726532›Full record

ArticleRadiology2022

Symmetric CTA Collaterals Identify Patients with Slow-progressing Stroke Likely to Benefit from Late Thrombectomy.

Robert W Regenhardt, R Gilberto González, Julian He, Michael H Lev, Aneesh B Singhal

Abstract read
In one paragraph

Article in Radiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
23citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

23 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Review
  6. Multi-phase CT-Angiography outperforms angiographic careggi collateral score and predicts functional outcome in acute ischemic stroke.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025
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  15. In a hub-and-spoke network, spoke-administered thrombolysis reduces mechanical thrombectomy procedure time and number of passes.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2023
    Article
  16. Structural and functional imaging of brains.Science China. Chemistry · 2023
    Review
  17. Article
  18. Article
  19. Article
  20. Diagnosis of Ischemic Stroke: As Simple as Possible.Diagnostics (Basel, Switzerland) · 2022
    Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors.

Robert W Regenhardt *From the Departments of Neurology (R.W.R., A.B.S.), Neurosurgery (R.W.R.), and Radiology (R.G.G., J.H., M.H.L.), Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, WACC 729C, Boston, MA 02114; Athinoula A Martinos Center for Biomedical Imaging, Charlestown, Mass (R.G.G.); and Mass General Brigham Center for Clinical Data Science, Boston, Mass (R.G.G.).ORCID 0000-0003-2958-3484
R Gilberto González *From the Departments of Neurology (R.W.R., A.B.S.), Neurosurgery (R.W.R.), and Radiology (R.G.G., J.H., M.H.L.), Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, WACC 729C, Boston, MA 02114; Athinoula A Martinos Center for Biomedical Imaging, Charlestown, Mass (R.G.G.); and Mass General Brigham Center for Clinical Data Science, Boston, Mass (R.G.G.).ORCID 0000-0002-0234-3897
Julian HeFrom the Departments of Neurology (R.W.R., A.B.S.), Neurosurgery (R.W.R.), and Radiology (R.G.G., J.H., M.H.L.), Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, WACC 729C, Boston, MA 02114; Athinoula A Martinos Center for Biomedical Imaging, Charlestown, Mass (R.G.G.); and Mass General Brigham Center for Clinical Data Science, Boston, Mass (R.G.G.).ORCID 0000-0002-4779-1538
Michael H LevFrom the Departments of Neurology (R.W.R., A.B.S.), Neurosurgery (R.W.R.), and Radiology (R.G.G., J.H., M.H.L.), Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, WACC 729C, Boston, MA 02114; Athinoula A Martinos Center for Biomedical Imaging, Charlestown, Mass (R.G.G.); and Mass General Brigham Center for Clinical Data Science, Boston, Mass (R.G.G.).ORCID 0000-0003-0236-7319
Aneesh B SinghalFrom the Departments of Neurology (R.W.R., A.B.S.), Neurosurgery (R.W.R.), and Radiology (R.G.G., J.H., M.H.L.), Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, WACC 729C, Boston, MA 02114; Athinoula A Martinos Center for Biomedical Imaging, Charlestown, Mass (R.G.G.); and Mass General Brigham Center for Clinical Data Science, Boston, Mass (R.G.G.).ORCID 0000-0002-2641-5277

Funding

AtRial Cardiopathy and Antithrombotic Drugs In prevention After cryptogenicstroke (ARCADIA)U01NS095869 · NINDS · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI BRODERICK, JOSEPH PAUL, KAMEL, HOOMAN · 2017 to 2022
$22.0M
Specialized Programs of Translational Research in Acute Stroke at the PartnersP50NS051343 · NINDS · MASSACHUSETTS GENERAL HOSPITAL · PI GREENBERG, STEVEN M · 2006 to 2013
$17.5M
Neuroscience Resident Research ProgramR25NS065743 · NINDS · MASSACHUSETTS GENERAL HOSPITAL · PI CASH, SYDNEY S, WILLIAMS, ZIV · 2009 to 2023
$11.8M
Imaging Human Brain Function with Minimal Mobility Restrictions - Supplement - NeuroethicsU01EB025153 · NIBIB · UNIVERSITY OF MINNESOTA · PI GARWOOD, MICHAEL · 2017 to 2021
$11.2M
Evaluation of brain recovery of stroke patients using a novel magnetic resonance compatible hand induced robotic device combined with magnetic resonance imagingR01NS105875 · NINDS · MASSACHUSETTS GENERAL HOSPITAL · PI TZIKA, A ARIA · 2018 to 2022
$3.4M
New England Regional Coordinating Center for the NINDS Stroke Trials Network (StrokeNet)U24NS107243 · NINDS · MASSACHUSETTS GENERAL HOSPITAL · PI ANEESH B SINGHAL · 2018 to 2026
$3.3M
Neuroscience Resident Research ProgramUE5NS065743 · NINDS · MASSACHUSETTS GENERAL HOSPITAL · PI SYDNEY S CASH, Ziv Williams · 2024 to 2026
$2.6M
Normobaric Hyperoxia in Acute Ischemic StrokeR01NS051412 · NINDS · MASSACHUSETTS GENERAL HOSPITAL · PI SINGHAL, ANEESH B · 2006 to 2010
$2.1M
NIBIB NIH HHS U01 EB025153NINDS NIH HHS P50 NS051343NINDS NIH HHS R01 NS051412NINDS NIH HHS R01 NS105875NINDS NIH HHS R25 NS065743NINDS NIH HHS U01 NS095869NINDS NIH HHS U24 NS107243NINDS NIH HHS UE5 NS065743
6 · The paper itself

Abstract

Background Understanding ischemic core growth rate (IGR) is key in identifying patients with slow-progressing large vessel occlusion (LVO) stroke who may benefit from delayed endovascular thrombectomy (EVT). Purpose To evaluate whether symmetric collateral pattern at CT angiography (CTA) can help to identify patients with low IGR and small 24-hour diffusion-weighted MRI ischemic core volume in patients with LVO not treated with reperfusion therapies. Materials and Methods In this secondary analysis of clinical trial data from before EVT became standard of care from January 2007 to June 2009, patients with anterior proximal LVO not treated with reperfusion therapies were evaluated. All patients underwent admission CTA and at least three MRI examinations at four time points over 48 hours. Arterial phase CTA collaterals at presentation were categorized as symmetric, malignant, or other. Diffusion-weighted MRI ischemic core volume and IGR at multiple time points were determined. The IGR at presentation was defined as follows: (ischemic core volume in cubic centimeters)/(time since stroke symptom onset in hours). Multivariable analyses and receiver operator characteristic analyses were used. Results This study evaluated 31 patients (median age, 71 years; interquartile range, 61-81 years; 19 men) with median National Institutes of Health Stroke Scale (NIHSS) score of 13. Collaterals were symmetric (45%; 14 of 31), malignant (13%; four of 31), or other (42%; 13 of 31). Median ischemic core volume was different between collateral patterns at all time points. Presentation was as follows: symmetric, 16 cm

Indexed as

Cerebral AngiographyComputed Tomography AngiographyDiffusion Magnetic Resonance ImagingAgedAged, 80 and overBrain IschemiaCollateral CirculationDisease ProgressionFemaleHumansMaleMiddle AgedStrokeThrombectomy

Identifiers

PMID34726532
PMCPMC8792270

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.