Evidence map›Paper›PMID 37813579›Full record

ArticleNeurology2023

Factors Associated With Fast Early Infarct Growth in Patients With Acute Ischemic Stroke With a Large Vessel Occlusion.

Pierre Seners, Nicole Yuen, Jean-Marc Olivot, Michael Mlynash, Jeremy J Heit, Soren Christensen, José Bernardo Escribano-Paredes, Emmanuel Carrera, Davide Strambo, Patrik Michel and 11 more

Abstract readMulticenter Study
In one paragraph

Article in Neurology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
28citing 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

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

  1. Pooled it
  2. Article
  3. Clinical Implications of Stroke Progressor Phenotypes defined based on ASPECTS decay and perfusion estimated infarct growth rate: insights from a large national thrombectomy registry.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026
    Article
  4. Article
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  7. Cerebral small vessel disease does not impair leptomeningeal collateral supply in large-vessel occlusion - Results from quantitative collateral mapping with MRI.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2026
    Article
  8. Article
  9. Article
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  11. Article
  12. Article
  13. Article
  14. Association of hypoperfusion intensity ratio and cerebral blood volume Index with good outcome in patients transferred for thrombectomy.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2025
    Article
  15. Review
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  18. Quantitative imaging outperforms No-reflow in predicting functional outcomes in a translational stroke model.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2025
    Article
  19. Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

21 authors.

Pierre SenersFrom the Stanford Stroke Center (P.S., N.Y., M.M., S.C., G.W.A.), Palo Alto, CA; Neurology Department (P.S., M.O.), Hôpital Fondation A. de Rothschild; Institut de Psychiatrie et Neurosciences de Paris (IPNP) (P.S.), U1266, INSERM, Paris; Acute Stroke Unit (J.M.O., J.-F.A.), Hôpital Pierre-Paul Riquet, CHU Toulouse and CIC 1436, Toulouse University, INSERM, UPS, France; Radiology Department (J.J.H.), Stanford University, Palo Alto, CA; Neurology Department (J.B.E.P., E.C.), Geneva University Hospital, Switzerland; Stroke Center (D.S., P.M., A.S.), Neurology Service, Lausanne University Hospital and University of Lausanne, Switzerland; Neuroradiology Department (M.W., H.C.), MD Anderson Cancer Center, University of Texas, Houston; Neuroradiology Department (C.C.), Toulouse University Hospital; Stroke Unit (I.S., J.S.), Bordeaux University Hospital; and Radiology Department (M.G.L.), Hôpital Fondation A. de Rothschild, Paris, France. pierre.seners@gmail.com.ORCID 0000-0002-2134-0691
Nicole YuenFrom the Stanford Stroke Center (P.S., N.Y., M.M., S.C., G.W.A.), Palo Alto, CA; Neurology Department (P.S., M.O.), Hôpital Fondation A. de Rothschild; Institut de Psychiatrie et Neurosciences de Paris (IPNP) (P.S.), U1266, INSERM, Paris; Acute Stroke Unit (J.M.O., J.-F.A.), Hôpital Pierre-Paul Riquet, CHU Toulouse and CIC 1436, Toulouse University, INSERM, UPS, France; Radiology Department (J.J.H.), Stanford University, Palo Alto, CA; Neurology Department (J.B.E.P., E.C.), Geneva University Hospital, Switzerland; Stroke Center (D.S., P.M., A.S.), Neurology Service, Lausanne University Hospital and University of Lausanne, Switzerland; Neuroradiology Department (M.W., H.C.), MD Anderson Cancer Center, University of Texas, Houston; Neuroradiology Department (C.C.), Toulouse University Hospital; Stroke Unit (I.S., J.S.), Bordeaux University Hospital; and Radiology Department (M.G.L.), Hôpital Fondation A. de Rothschild, Paris, France.ORCID 0000-0003-3206-6656
Jean-Marc OlivotFrom the Stanford Stroke Center (P.S., N.Y., M.M., S.C., G.W.A.), Palo Alto, CA; Neurology Department (P.S., M.O.), Hôpital Fondation A. de Rothschild; Institut de Psychiatrie et Neurosciences de Paris (IPNP) (P.S.), U1266, INSERM, Paris; Acute Stroke Unit (J.M.O., J.-F.A.), Hôpital Pierre-Paul Riquet, CHU Toulouse and CIC 1436, Toulouse University, INSERM, UPS, France; Radiology Department (J.J.H.), Stanford University, Palo Alto, CA; Neurology Department (J.B.E.P., E.C.), Geneva University Hospital, Switzerland; Stroke Center (D.S., P.M., A.S.), Neurology Service, Lausanne University Hospital and University of Lausanne, Switzerland; Neuroradiology Department (M.W., H.C.), MD Anderson Cancer Center, University of Texas, Houston; Neuroradiology Department (C.C.), Toulouse University Hospital; Stroke Unit (I.S., J.S.), Bordeaux University Hospital; and Radiology Department (M.G.L.), Hôpital Fondation A. de Rothschild, Paris, France.ORCID 0000-0003-2027-2276
Michael MlynashFrom the Stanford Stroke Center (P.S., N.Y., M.M., S.C., G.W.A.), Palo Alto, CA; Neurology Department (P.S., M.O.), Hôpital Fondation A. de Rothschild; Institut de Psychiatrie et Neurosciences de Paris (IPNP) (P.S.), U1266, INSERM, Paris; Acute Stroke Unit (J.M.O., J.-F.A.), Hôpital Pierre-Paul Riquet, CHU Toulouse and CIC 1436, Toulouse University, INSERM, UPS, France; Radiology Department (J.J.H.), Stanford University, Palo Alto, CA; Neurology Department (J.B.E.P., E.C.), Geneva University Hospital, Switzerland; Stroke Center (D.S., P.M., A.S.), Neurology Service, Lausanne University Hospital and University of Lausanne, Switzerland; Neuroradiology Department (M.W., H.C.), MD Anderson Cancer Center, University of Texas, Houston; Neuroradiology Department (C.C.), Toulouse University Hospital; Stroke Unit (I.S., J.S.), Bordeaux University Hospital; and Radiology Department (M.G.L.), Hôpital Fondation A. de Rothschild, Paris, France.ORCID 0000-0001-7483-8699
Jeremy J HeitFrom the Stanford Stroke Center (P.S., N.Y., M.M., S.C., G.W.A.), Palo Alto, CA; Neurology Department (P.S., M.O.), Hôpital Fondation A. de Rothschild; Institut de Psychiatrie et Neurosciences de Paris (IPNP) (P.S.), U1266, INSERM, Paris; Acute Stroke Unit (J.M.O., J.-F.A.), Hôpital Pierre-Paul Riquet, CHU Toulouse and CIC 1436, Toulouse University, INSERM, UPS, France; Radiology Department (J.J.H.), Stanford University, Palo Alto, CA; Neurology Department (J.B.E.P., E.C.), Geneva University Hospital, Switzerland; Stroke Center (D.S., P.M., A.S.), Neurology Service, Lausanne University Hospital and University of Lausanne, Switzerland; Neuroradiology Department (M.W., H.C.), MD Anderson Cancer Center, University of Texas, Houston; Neuroradiology Department (C.C.), Toulouse University Hospital; Stroke Unit (I.S., J.S.), Bordeaux University Hospital; and Radiology Department (M.G.L.), Hôpital Fondation A. de Rothschild, Paris, France.ORCID 0000-0003-1055-8000
Soren ChristensenFrom the Stanford Stroke Center (P.S., N.Y., M.M., S.C., G.W.A.), Palo Alto, CA; Neurology Department (P.S., M.O.), Hôpital Fondation A. de Rothschild; Institut de Psychiatrie et Neurosciences de Paris (IPNP) (P.S.), U1266, INSERM, Paris; Acute Stroke Unit (J.M.O., J.-F.A.), Hôpital Pierre-Paul Riquet, CHU Toulouse and CIC 1436, Toulouse University, INSERM, UPS, France; Radiology Department (J.J.H.), Stanford University, Palo Alto, CA; Neurology Department (J.B.E.P., E.C.), Geneva University Hospital, Switzerland; Stroke Center (D.S., P.M., A.S.), Neurology Service, Lausanne University Hospital and University of Lausanne, Switzerland; Neuroradiology Department (M.W., H.C.), MD Anderson Cancer Center, University of Texas, Houston; Neuroradiology Department (C.C.), Toulouse University Hospital; Stroke Unit (I.S., J.S.), Bordeaux University Hospital; and Radiology Department (M.G.L.), Hôpital Fondation A. de Rothschild, Paris, France.ORCID 0000-0003-1242-3724
José Bernardo Escribano-ParedesFrom the Stanford Stroke Center (P.S., N.Y., M.M., S.C., G.W.A.), Palo Alto, CA; Neurology Department (P.S., M.O.), Hôpital Fondation A. de Rothschild; Institut de Psychiatrie et Neurosciences de Paris (IPNP) (P.S.), U1266, INSERM, Paris; Acute Stroke Unit (J.M.O., J.-F.A.), Hôpital Pierre-Paul Riquet, CHU Toulouse and CIC 1436, Toulouse University, INSERM, UPS, France; Radiology Department (J.J.H.), Stanford University, Palo Alto, CA; Neurology Department (J.B.E.P., E.C.), Geneva University Hospital, Switzerland; Stroke Center (D.S., P.M., A.S.), Neurology Service, Lausanne University Hospital and University of Lausanne, Switzerland; Neuroradiology Department (M.W., H.C.), MD Anderson Cancer Center, University of Texas, Houston; Neuroradiology Department (C.C.), Toulouse University Hospital; Stroke Unit (I.S., J.S.), Bordeaux University Hospital; and Radiology Department (M.G.L.), Hôpital Fondation A. de Rothschild, Paris, France.ORCID 0000-0003-0534-7962
Emmanuel CarreraFrom the Stanford Stroke Center (P.S., N.Y., M.M., S.C., G.W.A.), Palo Alto, CA; Neurology Department (P.S., M.O.), Hôpital Fondation A. de Rothschild; Institut de Psychiatrie et Neurosciences de Paris (IPNP) (P.S.), U1266, INSERM, Paris; Acute Stroke Unit (J.M.O., J.-F.A.), Hôpital Pierre-Paul Riquet, CHU Toulouse and CIC 1436, Toulouse University, INSERM, UPS, France; Radiology Department (J.J.H.), Stanford University, Palo Alto, CA; Neurology Department (J.B.E.P., E.C.), Geneva University Hospital, Switzerland; Stroke Center (D.S., P.M., A.S.), Neurology Service, Lausanne University Hospital and University of Lausanne, Switzerland; Neuroradiology Department (M.W., H.C.), MD Anderson Cancer Center, University of Texas, Houston; Neuroradiology Department (C.C.), Toulouse University Hospital; Stroke Unit (I.S., J.S.), Bordeaux University Hospital; and Radiology Department (M.G.L.), Hôpital Fondation A. de Rothschild, Paris, France.ORCID 0000-0003-0045-5382
Davide StramboFrom the Stanford Stroke Center (P.S., N.Y., M.M., S.C., G.W.A.), Palo Alto, CA; Neurology Department (P.S., M.O.), Hôpital Fondation A. de Rothschild; Institut de Psychiatrie et Neurosciences de Paris (IPNP) (P.S.), U1266, INSERM, Paris; Acute Stroke Unit (J.M.O., J.-F.A.), Hôpital Pierre-Paul Riquet, CHU Toulouse and CIC 1436, Toulouse University, INSERM, UPS, France; Radiology Department (J.J.H.), Stanford University, Palo Alto, CA; Neurology Department (J.B.E.P., E.C.), Geneva University Hospital, Switzerland; Stroke Center (D.S., P.M., A.S.), Neurology Service, Lausanne University Hospital and University of Lausanne, Switzerland; Neuroradiology Department (M.W., H.C.), MD Anderson Cancer Center, University of Texas, Houston; Neuroradiology Department (C.C.), Toulouse University Hospital; Stroke Unit (I.S., J.S.), Bordeaux University Hospital; and Radiology Department (M.G.L.), Hôpital Fondation A. de Rothschild, Paris, France.ORCID 0000-0003-4429-2714
Patrik MichelFrom the Stanford Stroke Center (P.S., N.Y., M.M., S.C., G.W.A.), Palo Alto, CA; Neurology Department (P.S., M.O.), Hôpital Fondation A. de Rothschild; Institut de Psychiatrie et Neurosciences de Paris (IPNP) (P.S.), U1266, INSERM, Paris; Acute Stroke Unit (J.M.O., J.-F.A.), Hôpital Pierre-Paul Riquet, CHU Toulouse and CIC 1436, Toulouse University, INSERM, UPS, France; Radiology Department (J.J.H.), Stanford University, Palo Alto, CA; Neurology Department (J.B.E.P., E.C.), Geneva University Hospital, Switzerland; Stroke Center (D.S., P.M., A.S.), Neurology Service, Lausanne University Hospital and University of Lausanne, Switzerland; Neuroradiology Department (M.W., H.C.), MD Anderson Cancer Center, University of Texas, Houston; Neuroradiology Department (C.C.), Toulouse University Hospital; Stroke Unit (I.S., J.S.), Bordeaux University Hospital; and Radiology Department (M.G.L.), Hôpital Fondation A. de Rothschild, Paris, France.ORCID 0000-0003-4954-7579
Alexander SalernoFrom the Stanford Stroke Center (P.S., N.Y., M.M., S.C., G.W.A.), Palo Alto, CA; Neurology Department (P.S., M.O.), Hôpital Fondation A. de Rothschild; Institut de Psychiatrie et Neurosciences de Paris (IPNP) (P.S.), U1266, INSERM, Paris; Acute Stroke Unit (J.M.O., J.-F.A.), Hôpital Pierre-Paul Riquet, CHU Toulouse and CIC 1436, Toulouse University, INSERM, UPS, France; Radiology Department (J.J.H.), Stanford University, Palo Alto, CA; Neurology Department (J.B.E.P., E.C.), Geneva University Hospital, Switzerland; Stroke Center (D.S., P.M., A.S.), Neurology Service, Lausanne University Hospital and University of Lausanne, Switzerland; Neuroradiology Department (M.W., H.C.), MD Anderson Cancer Center, University of Texas, Houston; Neuroradiology Department (C.C.), Toulouse University Hospital; Stroke Unit (I.S., J.S.), Bordeaux University Hospital; and Radiology Department (M.G.L.), Hôpital Fondation A. de Rothschild, Paris, France.ORCID 0000-0001-8494-5527
Max WintermarkFrom the Stanford Stroke Center (P.S., N.Y., M.M., S.C., G.W.A.), Palo Alto, CA; Neurology Department (P.S., M.O.), Hôpital Fondation A. de Rothschild; Institut de Psychiatrie et Neurosciences de Paris (IPNP) (P.S.), U1266, INSERM, Paris; Acute Stroke Unit (J.M.O., J.-F.A.), Hôpital Pierre-Paul Riquet, CHU Toulouse and CIC 1436, Toulouse University, INSERM, UPS, France; Radiology Department (J.J.H.), Stanford University, Palo Alto, CA; Neurology Department (J.B.E.P., E.C.), Geneva University Hospital, Switzerland; Stroke Center (D.S., P.M., A.S.), Neurology Service, Lausanne University Hospital and University of Lausanne, Switzerland; Neuroradiology Department (M.W., H.C.), MD Anderson Cancer Center, University of Texas, Houston; Neuroradiology Department (C.C.), Toulouse University Hospital; Stroke Unit (I.S., J.S.), Bordeaux University Hospital; and Radiology Department (M.G.L.), Hôpital Fondation A. de Rothschild, Paris, France.ORCID 0000-0002-6726-3951
Hui ChenFrom the Stanford Stroke Center (P.S., N.Y., M.M., S.C., G.W.A.), Palo Alto, CA; Neurology Department (P.S., M.O.), Hôpital Fondation A. de Rothschild; Institut de Psychiatrie et Neurosciences de Paris (IPNP) (P.S.), U1266, INSERM, Paris; Acute Stroke Unit (J.M.O., J.-F.A.), Hôpital Pierre-Paul Riquet, CHU Toulouse and CIC 1436, Toulouse University, INSERM, UPS, France; Radiology Department (J.J.H.), Stanford University, Palo Alto, CA; Neurology Department (J.B.E.P., E.C.), Geneva University Hospital, Switzerland; Stroke Center (D.S., P.M., A.S.), Neurology Service, Lausanne University Hospital and University of Lausanne, Switzerland; Neuroradiology Department (M.W., H.C.), MD Anderson Cancer Center, University of Texas, Houston; Neuroradiology Department (C.C.), Toulouse University Hospital; Stroke Unit (I.S., J.S.), Bordeaux University Hospital; and Radiology Department (M.G.L.), Hôpital Fondation A. de Rothschild, Paris, France.ORCID 0000-0002-4479-0185
Jean-François AlbucherFrom the Stanford Stroke Center (P.S., N.Y., M.M., S.C., G.W.A.), Palo Alto, CA; Neurology Department (P.S., M.O.), Hôpital Fondation A. de Rothschild; Institut de Psychiatrie et Neurosciences de Paris (IPNP) (P.S.), U1266, INSERM, Paris; Acute Stroke Unit (J.M.O., J.-F.A.), Hôpital Pierre-Paul Riquet, CHU Toulouse and CIC 1436, Toulouse University, INSERM, UPS, France; Radiology Department (J.J.H.), Stanford University, Palo Alto, CA; Neurology Department (J.B.E.P., E.C.), Geneva University Hospital, Switzerland; Stroke Center (D.S., P.M., A.S.), Neurology Service, Lausanne University Hospital and University of Lausanne, Switzerland; Neuroradiology Department (M.W., H.C.), MD Anderson Cancer Center, University of Texas, Houston; Neuroradiology Department (C.C.), Toulouse University Hospital; Stroke Unit (I.S., J.S.), Bordeaux University Hospital; and Radiology Department (M.G.L.), Hôpital Fondation A. de Rothschild, Paris, France.ORCID 0000-0003-2415-3856
Christophe CognardFrom the Stanford Stroke Center (P.S., N.Y., M.M., S.C., G.W.A.), Palo Alto, CA; Neurology Department (P.S., M.O.), Hôpital Fondation A. de Rothschild; Institut de Psychiatrie et Neurosciences de Paris (IPNP) (P.S.), U1266, INSERM, Paris; Acute Stroke Unit (J.M.O., J.-F.A.), Hôpital Pierre-Paul Riquet, CHU Toulouse and CIC 1436, Toulouse University, INSERM, UPS, France; Radiology Department (J.J.H.), Stanford University, Palo Alto, CA; Neurology Department (J.B.E.P., E.C.), Geneva University Hospital, Switzerland; Stroke Center (D.S., P.M., A.S.), Neurology Service, Lausanne University Hospital and University of Lausanne, Switzerland; Neuroradiology Department (M.W., H.C.), MD Anderson Cancer Center, University of Texas, Houston; Neuroradiology Department (C.C.), Toulouse University Hospital; Stroke Unit (I.S., J.S.), Bordeaux University Hospital; and Radiology Department (M.G.L.), Hôpital Fondation A. de Rothschild, Paris, France.ORCID 0000-0003-4287-2627
Igor SibonFrom the Stanford Stroke Center (P.S., N.Y., M.M., S.C., G.W.A.), Palo Alto, CA; Neurology Department (P.S., M.O.), Hôpital Fondation A. de Rothschild; Institut de Psychiatrie et Neurosciences de Paris (IPNP) (P.S.), U1266, INSERM, Paris; Acute Stroke Unit (J.M.O., J.-F.A.), Hôpital Pierre-Paul Riquet, CHU Toulouse and CIC 1436, Toulouse University, INSERM, UPS, France; Radiology Department (J.J.H.), Stanford University, Palo Alto, CA; Neurology Department (J.B.E.P., E.C.), Geneva University Hospital, Switzerland; Stroke Center (D.S., P.M., A.S.), Neurology Service, Lausanne University Hospital and University of Lausanne, Switzerland; Neuroradiology Department (M.W., H.C.), MD Anderson Cancer Center, University of Texas, Houston; Neuroradiology Department (C.C.), Toulouse University Hospital; Stroke Unit (I.S., J.S.), Bordeaux University Hospital; and Radiology Department (M.G.L.), Hôpital Fondation A. de Rothschild, Paris, France.ORCID 0000-0002-1171-4215
Michael ObadiaFrom the Stanford Stroke Center (P.S., N.Y., M.M., S.C., G.W.A.), Palo Alto, CA; Neurology Department (P.S., M.O.), Hôpital Fondation A. de Rothschild; Institut de Psychiatrie et Neurosciences de Paris (IPNP) (P.S.), U1266, INSERM, Paris; Acute Stroke Unit (J.M.O., J.-F.A.), Hôpital Pierre-Paul Riquet, CHU Toulouse and CIC 1436, Toulouse University, INSERM, UPS, France; Radiology Department (J.J.H.), Stanford University, Palo Alto, CA; Neurology Department (J.B.E.P., E.C.), Geneva University Hospital, Switzerland; Stroke Center (D.S., P.M., A.S.), Neurology Service, Lausanne University Hospital and University of Lausanne, Switzerland; Neuroradiology Department (M.W., H.C.), MD Anderson Cancer Center, University of Texas, Houston; Neuroradiology Department (C.C.), Toulouse University Hospital; Stroke Unit (I.S., J.S.), Bordeaux University Hospital; and Radiology Department (M.G.L.), Hôpital Fondation A. de Rothschild, Paris, France.ORCID 0000-0001-6777-6311
Julien SavatovskyFrom the Stanford Stroke Center (P.S., N.Y., M.M., S.C., G.W.A.), Palo Alto, CA; Neurology Department (P.S., M.O.), Hôpital Fondation A. de Rothschild; Institut de Psychiatrie et Neurosciences de Paris (IPNP) (P.S.), U1266, INSERM, Paris; Acute Stroke Unit (J.M.O., J.-F.A.), Hôpital Pierre-Paul Riquet, CHU Toulouse and CIC 1436, Toulouse University, INSERM, UPS, France; Radiology Department (J.J.H.), Stanford University, Palo Alto, CA; Neurology Department (J.B.E.P., E.C.), Geneva University Hospital, Switzerland; Stroke Center (D.S., P.M., A.S.), Neurology Service, Lausanne University Hospital and University of Lausanne, Switzerland; Neuroradiology Department (M.W., H.C.), MD Anderson Cancer Center, University of Texas, Houston; Neuroradiology Department (C.C.), Toulouse University Hospital; Stroke Unit (I.S., J.S.), Bordeaux University Hospital; and Radiology Department (M.G.L.), Hôpital Fondation A. de Rothschild, Paris, France.ORCID 0000-0002-6732-1779
Maarten G LansbergFrom the Stanford Stroke Center (P.S., N.Y., M.M., S.C., G.W.A.), Palo Alto, CA; Neurology Department (P.S., M.O.), Hôpital Fondation A. de Rothschild; Institut de Psychiatrie et Neurosciences de Paris (IPNP) (P.S.), U1266, INSERM, Paris; Acute Stroke Unit (J.M.O., J.-F.A.), Hôpital Pierre-Paul Riquet, CHU Toulouse and CIC 1436, Toulouse University, INSERM, UPS, France; Radiology Department (J.J.H.), Stanford University, Palo Alto, CA; Neurology Department (J.B.E.P., E.C.), Geneva University Hospital, Switzerland; Stroke Center (D.S., P.M., A.S.), Neurology Service, Lausanne University Hospital and University of Lausanne, Switzerland; Neuroradiology Department (M.W., H.C.), MD Anderson Cancer Center, University of Texas, Houston; Neuroradiology Department (C.C.), Toulouse University Hospital; Stroke Unit (I.S., J.S.), Bordeaux University Hospital; and Radiology Department (M.G.L.), Hôpital Fondation A. de Rothschild, Paris, France.ORCID 0000-0002-3545-6927
Gregory W AlbersFrom the Stanford Stroke Center (P.S., N.Y., M.M., S.C., G.W.A.), Palo Alto, CA; Neurology Department (P.S., M.O.), Hôpital Fondation A. de Rothschild; Institut de Psychiatrie et Neurosciences de Paris (IPNP) (P.S.), U1266, INSERM, Paris; Acute Stroke Unit (J.M.O., J.-F.A.), Hôpital Pierre-Paul Riquet, CHU Toulouse and CIC 1436, Toulouse University, INSERM, UPS, France; Radiology Department (J.J.H.), Stanford University, Palo Alto, CA; Neurology Department (J.B.E.P., E.C.), Geneva University Hospital, Switzerland; Stroke Center (D.S., P.M., A.S.), Neurology Service, Lausanne University Hospital and University of Lausanne, Switzerland; Neuroradiology Department (M.W., H.C.), MD Anderson Cancer Center, University of Texas, Houston; Neuroradiology Department (C.C.), Toulouse University Hospital; Stroke Unit (I.S., J.S.), Bordeaux University Hospital; and Radiology Department (M.G.L.), Hôpital Fondation A. de Rothschild, Paris, France.ORCID 0000-0003-0263-4632
for Mismatch Prevalence

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

objectivesThe optimal methods for predicting early infarct growth rate (EIGR) in acute ischemic stroke with a large vessel occlusion (LVO) have not been established. We aimed to study the factors associated with EIGR, with a focus on the collateral circulation as assessed by the hypoperfusion intensity ratio (HIR) on perfusion imaging, and determine whether the associations found are consistent across imaging modalities.

methodsRetrospective multicenter international study including patients with anterior circulation LVO-related acute stroke with witnessed stroke onset and baseline perfusion imaging (MRI or CT) performed within 24 hours from symptom onset. To avoid selection bias, patients were selected from (1) the prospective registries of 4 comprehensive stroke centers with systematic use of perfusion imaging and including both thrombectomy-treated and untreated patients and (2) 1 prospective thrombectomy study where perfusion imaging was acquired per protocol, but treatment decisions were made blinded to the results. EIGR was defined as infarct volume on baseline imaging divided by onset-to-imaging time and fast progressors as EIGR ≥10 mL/h. The HIR, defined as the proportion of time-to-maximum (Tmax) >6 second with Tmax >10 second volume, was measured on perfusion imaging using RAPID software. The factors independently associated with fast progression were studied using multivariable logistic regression models, with separate analyses for CT- and MRI-assessed patients.

resultsOverall, 1,127 patients were included (CT, n = 471; MRI, n = 656). Median age was 74 years (interquartile range [IQR] 62-83), 52% were male, median NIH Stroke Scale was 16 (IQR 9-21), median HIR was 0.42 (IQR 0.26-0.58), and 415 (37%) were fast progressors. The HIR was the primary factor associated with fast progression, with very similar results across imaging modalities: The proportion of fast progressors was 4% in the first HIR quartile (i.e., excellent collaterals), ∼15% in the second, ∼50% in the third, and ∼77% in the fourth ( DISCUSSION: The HIR is the primary factor associated with fast infarct progression, regardless of imaging modality. These results have implication for neuroprotection trial design, as well as informing triage decisions at primary stroke centers.

Indexed as

Brain IschemiaIschemic StrokeStrokeAgedFemaleHumansInfarctionMagnetic Resonance ImagingMaleProspective StudiesRetrospective StudiesThrombectomyTreatment Outcome

Identifiers

PMID37813579
PMCPMC10663035

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