ArticleJournal of thrombosis and thrombolysis2023
Hyperdense middle cerebral artery sign predicts favorable outcome in patients undergoing mechanical thrombectomy.
Article in Journal of thrombosis and thrombolysis, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 2 of them syntheses that pooled it.
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Who cites it
19 citing papers in PubMed, 2 syntheses or guidelines pooled it, 23 citations in OpenAlex.
- Hyperdense sign as a predictor for successful recanalization and clinical outcome in acute ischemic stroke: A systematic review and meta-analysis.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2026Pooled it
- Outcomes of mechanical thrombectomy in M1 occlusion patients with or without hyperdense middle cerebral artery sign: A systematic review and meta-analysis.The neuroradiology journal · 2024Pooled it
- Letter to the editor concerning the article by Herega and colleagues, "Hyperdense middle cerebral artery sign is not associated with functional outcome following mechanical thrombectomy".Neuroradiology · 2026Article
- Hyperdense middle cerebral artery sign is not associated with functional outcome following mechanical thrombectomy.Neuroradiology · 2026Article
- Intracranial Hemorrhage After Mechanical Thrombectomy: Proximal Versus Distal MCA M1 Occlusions.Brain and behavior · 2026Article
- Prognostic value of the hyperdense middle cerebral artery sign in patients undergoing mechanical thrombectomy.Medicine · 2026Article
- High-density lipoprotein cholesterol levels and their impact on outcomes in acute ischemic stroke patients treated with mechanical thrombectomy.International journal of stroke : official journal of the International Stroke Society · 2026Observational
- Hyperdense middle cerebral artery sign is a prognostic factor of favourable long-term outcomes of mechanical thrombectomy in acute ischaemic stroke.Neuroradiology · 2026Article
- Impact of atrial fibrillation on outcomes in stroke patients with tandem occlusions treated with thrombectomy: A multicentre study.International journal of stroke : official journal of the International Stroke Society · 2025Article
- C-reactive protein elevation and subsequent atrial fibrillation detection after ischemic stroke treated with mechanical thrombectomy: An inverse probability weighting analysis.International journal of stroke : official journal of the International Stroke Society · 2025Observational
- Outcomes of different anesthesia techniques in nonagenarians treated with mechanical thrombectomy for anterior circulation large vessel occlusion: An inverse probability weighting analysis.European stroke journal · 2025Article
- Age-Specific Differences in Inflammatory Biomarkers and Their Impact on Futile Recanalization After Mechanical Thrombectomy: An Inverse Probability Weighting Analysis.European journal of neurology · 2025Observational
- CT-Based Intrathrombus and Perithrombus Radiomics for Prediction of Prognosis after Endovascular Thrombectomy: A Retrospective Study across 2 Centers.AJNR. American journal of neuroradiology · 2025Article
- Predictors of futile recanalization after intravenous thrombolysis in stroke patients transferred for endovascular treatment.Journal of thrombosis and thrombolysis · 2025Article
- Does Hyperdense Middle Cerebral Artery Sign Predict the Prognosis of Patients Undergoing Emergency Endovascular Treatment?Current neurovascular research · 2025Article
- Impact of Sex on Clinical Outcomes of Tandem Occlusion in Acute Ischemic Stroke Patients Treated With Mechanical Thrombectomy. A Propensity-Matched Analysis.European journal of neurology · 2025Observational
- Sex-based differences in inflammatory predictors of outcomes in patients undergoing mechanical thrombectomy: an inverse probability weighting analysis.Therapeutic advances in neurological disorders · 2025Article
- Predictors of futile recanalization in nonagenarians treated with mechanical thrombectomy: a multi-center observational study.Journal of neurology · 2024Observational
- Minimal Imaging Requirements.Journal of neuroendovascular therapy · 2023Review
Corrections and comments
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Authors and funding
13 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Non-contrast computer tomography detects the presence of hyperdense middle cerebral artery sign (HMCAS). Studies on the prognostic value of HMCAS among patients undergoing mechanical thrombectomy (MT) are conflicting. A retrospective analysis of consecutive patients with acute ischemic stroke due to middle cerebral artery occlusion, presenting with or without HMCAS, who underwent MT, was performed. We enrolled 191 patients (HMCAS +, n = 140; HMCAS -, n = 51). Prevalence of successful recanalization was significantly higher in patients with HMCAS than in those without HMCAS (92.1% versus 74.5%, p = 0.001). Patients with HMCAS had a better clinical outcome than those HMCAS - (54.3% versus 37.3%, p = 0.037, for three-month favorable outcome; 62.9% versus 39.3%, p = 0.004, for major neurological improvement at discharge; 8.6% versus 19.6%, p = 0.035, for in-hospital mortality; 14.3% versus 27.5%, p = 0.035, for intracranial hemorrhage; 2.9% versus 17.6%, p = 0.001, for symptomatic intracranial hemorrhage). Multivariate analyses confirmed that HMCAS represents an independent predictor of three-month favorable outcome (OR 2.48, 95% CI 1.10-5.58, p = 0.028), major neurological improvement at discharge (OR 2.40, 95% CI 1.09-5.20, p = 0.030), in-hospital mortality (OR 0.29, 95% CI 0.010-0.81, p = 0.018), presence of ICH (OR 0.49, 95% CI 0.25-0.97, p = 0.042) and presence of SICH (OR 0.16, 95% CI 0.04-0.63, p = 0.009). HMCAS presence predicts favorable outcome in patients undergoing MT. This result may indicate that hyperdense clots are more likely to respond to MT than isodense ones. This effect is mediated by reduction in hemorrhagic transformation.
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