Evidence map›Paper›PMID 38997048›Full record

ArticleJournal of stroke and cerebrovascular diseases : the official journal of National Stroke Association2024

Infarct density defined by ADC threshold is associated with long-term functional outcome after endovascular thrombectomy.

Christopher G Favilla, Heta Patel, Mohammad Hossein Abassi, Jesse Thon, Michael T Mullen, Scott E Kasner, Jae W Song, Stephanie Cummings, Steven R Messé

Abstract read
In one paragraph

Article in Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–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

2 citing papers in PubMed.

  1. Article
  2. 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

9 authors.

Christopher G FavillaUniversity of Pennsylvania, Department of Neurology, Philadelphia, PA, USA. Electronic address: Christopher.favilla@pennmedicine.upenn.edu.
Heta PatelUniversity of Pennsylvania, Department of Neurology, Philadelphia, PA, USA.
Mohammad Hossein AbassiUniversity of Pennsylvania, Department of Neurology, Philadelphia, PA, USA.
Jesse ThonCooper University, Department of Neurology, Camden, NJ, USA.
Michael T MullenTemple University, Department of Neurology, Philadelphia, PA, USA.
Scott E KasnerUniversity of Pennsylvania, Department of Neurology, Philadelphia, PA, USA.
Jae W SongUniversity of Pennsylvania, Department of Radiology, Philadelphia, PA, USA.
Stephanie CummingsUniversity of Pennsylvania, Department of Neurology, Philadelphia, PA, USA.
Steven R MesséUniversity of Pennsylvania, Department of Neurology, Philadelphia, PA, USA.

Funding

Optical Monitoring of Cerebral Hemodynamics during Mechanical ThrombectomyK23NS110993 · NINDS · UNIVERSITY OF PENNSYLVANIA · PI FAVILLA, CHRISTOPHER G. · 2019 to 2023
$1.0M
NINDS NIH HHS K23 NS110993
6 · The paper itself

Abstract

objectivesEndovascular thrombectomy (EVT) dramatically improves clinical outcomes, but the reduction in final infarct volume only accounts for 10-15 % of the treatment benefit. We aimed to develop a novel MRI-ADC-based metric that quantify the degree of tissue injury to test the hypothesis that it outperforms infarct volume in predicting long-term outcome. MATERIALS AND

methodsA single-center cohort consisted of consecutive acute stroke patients with anterior circulation large vessel occlusion, successful recanalization via EVT (mTICI ≥2b), and MRI of the brain between 12 h and 7 days post-EVT. Imaging was processed via RAPID software. Final infarct volume was based on the traditional ADC <620 threshold. Logistic regression quantified the association of lesion volumes and good outcome (90-day modified Rankin Scale ≤2) at a range of lower ADC thresholds (<570, <520, and <470). Infarct density was calculated as the percentage of the final infarct volume below the ADC threshold with the greatest effect size. Univariate and multivariate logistic regression quantified the association between imaging/clinical metrics and functional outcome.

results120 patients underwent MRI after successful EVT. Lesion volume based on the ADC threshold <470 had the strongest association with good outcome (OR: 0.81 per 10 mL; 95 % CI: 0.66-0.99). In a multivariate model, infarct density (<470/<620 * 100) was independently associated with good outcome (aOR 0.68 per 10 %; 95 % CI: 0.49-0.95), but final infarct volume was not (aOR 0.98 per 10 mL; 95 % CI: 0.85-1.14).

conclusionsInfarct density after EVT is more strongly associated with long-term clinical outcome than infarct volume.

Indexed as

Diffusion Magnetic Resonance ImagingDisability EvaluationEndovascular ProceduresFunctional StatusPredictive Value of TestsRecovery of FunctionThrombectomyAgedAged, 80 and overFemaleHumansImage Interpretation, Computer-AssistedIschemic StrokeMaleMiddle AgedRetrospective StudiesADCEndovascular therapyImaging biomarkerIschemic strokeMRIStroke

Identifiers

PMID38997048
PMCPMC11380574

What OpenQuestion holds

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Registered trials

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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.