Evidence map›Paper›PMID 39145382›Full record

ArticleStroke2024

Perfusion Abnormalities on 24-Hour Perfusion Imaging in Patients With Complete Endovascular Reperfusion.

Adnan Mujanovic, Anick Imhof, Shaokai Zheng, Eike I Piechowiak, Bettina L Serrallach, Thomas R Meinel, Tomas Dobrocky, Yasmin N Aziz, David J Seiffge, Martina Goeldlin and 8 more

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PubMed Full text at PMC Publisher
In one paragraph

Article in Stroke, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed, 2 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

21 citing papers in PubMed, 2 syntheses or guidelines pooled it.

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  19. Hyperemia detection on arterial spin labeling is associated with final infarct volume in stroke post-endovascular therapy.Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association · 2025
    Observational
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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

18 authors.

Adnan MujanovicDepartment of Diagnostic and Interventional Neuroradiology (A.M., A.I., S.Z., E.I.P., B.L.S., T.D., A.H., R.W., J.G., J.K.), University of Bern, Switzerland.ORCID 0000-0002-6839-7134
Anick ImhofDepartment of Diagnostic and Interventional Neuroradiology (A.M., A.I., S.Z., E.I.P., B.L.S., T.D., A.H., R.W., J.G., J.K.), University of Bern, Switzerland.
Shaokai ZhengDepartment of Diagnostic and Interventional Neuroradiology (A.M., A.I., S.Z., E.I.P., B.L.S., T.D., A.H., R.W., J.G., J.K.), University of Bern, Switzerland.
Eike I PiechowiakDepartment of Diagnostic and Interventional Neuroradiology (A.M., A.I., S.Z., E.I.P., B.L.S., T.D., A.H., R.W., J.G., J.K.), University of Bern, Switzerland.ORCID 0000-0001-5609-0998
Bettina L SerrallachDepartment of Diagnostic and Interventional Neuroradiology (A.M., A.I., S.Z., E.I.P., B.L.S., T.D., A.H., R.W., J.G., J.K.), University of Bern, Switzerland.ORCID 0000-0002-1301-7798
Thomas R MeinelDepartment of Neurology, University Hospital Bern, Inselspital (T.R.M., D.J.S., M.G., M.A., U.F.), University of Bern, Switzerland.ORCID 0000-0002-0647-9273
Tomas DobrockyDepartment of Diagnostic and Interventional Neuroradiology (A.M., A.I., S.Z., E.I.P., B.L.S., T.D., A.H., R.W., J.G., J.K.), University of Bern, Switzerland.ORCID 0000-0002-6167-3343
Yasmin N AzizDepartment of Neurology, UC Medical Center, University of Cincinnati, Ohio (Y.N.A., E.A.M.).ORCID 0000-0002-3515-4005
David J SeiffgeDepartment of Neurology, University Hospital Bern, Inselspital (T.R.M., D.J.S., M.G., M.A., U.F.), University of Bern, Switzerland.ORCID 0000-0003-3890-3849
Martina GoeldlinDepartment of Neurology, University Hospital Bern, Inselspital (T.R.M., D.J.S., M.G., M.A., U.F.), University of Bern, Switzerland.ORCID 0000-0001-5800-116X
Marcel ArnoldDepartment of Neurology, University Hospital Bern, Inselspital (T.R.M., D.J.S., M.G., M.A., U.F.), University of Bern, Switzerland.ORCID 0000-0002-4274-4644
Arsany HakimDepartment of Diagnostic and Interventional Neuroradiology (A.M., A.I., S.Z., E.I.P., B.L.S., T.D., A.H., R.W., J.G., J.K.), University of Bern, Switzerland.ORCID 0000-0001-9431-1069
Roland WiestDepartment of Diagnostic and Interventional Neuroradiology (A.M., A.I., S.Z., E.I.P., B.L.S., T.D., A.H., R.W., J.G., J.K.), University of Bern, Switzerland.ORCID 0000-0001-7030-2045
Jan GrallaDepartment of Diagnostic and Interventional Neuroradiology (A.M., A.I., S.Z., E.I.P., B.L.S., T.D., A.H., R.W., J.G., J.K.), University of Bern, Switzerland.ORCID 0000-0003-1953-9033
Eva A MistryDepartment of Neurology, UC Medical Center, University of Cincinnati, Ohio (Y.N.A., E.A.M.).ORCID 0000-0002-7426-3650
Urs FischerDepartment of Neurology, University Hospital Bern, Inselspital (T.R.M., D.J.S., M.G., M.A., U.F.), University of Bern, Switzerland.ORCID 0000-0003-0521-4051
Susanne WegenerDepartment of Neurology, University Hospital Zürich, University of Zürich, Switzerland (S.W.).ORCID 0000-0003-4369-7023
Johannes KaesmacherDepartment of Diagnostic and Interventional Neuroradiology (A.M., A.I., S.Z., E.I.P., B.L.S., T.D., A.H., R.W., J.G., J.K.), University of Bern, Switzerland.ORCID 0000-0002-9177-2289

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPerfusion abnormalities in the infarct and salvaged penumbra have been proposed as a potential reason for poor clinical outcome (modified Rankin Scale score >2) despite complete angiographic reperfusion (Thrombolysis in Cerebral Infarction [TICI3]). In this study, we aimed to identify different microvascular perfusion patterns and their association with clinical outcomes among TICI3 patients.

methodsUniversity Hospital Bern's stroke registry of all patients between February 2015 and December 2021. Macrovascular reperfusion was graded using the TICI scale. Microvascular reperfusion status was evaluated within the infarct area on cerebral blood volume and cerebral blood flow perfusion maps obtained 24-hour postintervention. Primary outcome was functional independence (90-day modified Rankin Scale score 0-2) evaluated with the logistic regression analysis adjusted for age, sex, and 24-hour infarct volume from follow-up imaging.

resultsBased on microvascular perfusion findings, the entire cohort (N=248) was stratified into one of the 4 clusters: (1) normoperfusion (no perfusion abnormalities; n=143/248); (2) hyperperfusion (hyperperfusion on both cerebral blood volume and cerebral blood flow; n=54/248); (3) hypoperfusion (hypoperfusion on both cerebral blood volume and cerebral blood flow; n=14/248); and (4) mixed (discrepant findings, eg, cerebral blood volume hypoperfusion and cerebral blood flow hyperperfusion; n=37/248). Compared with the normoperfusion cluster, patients in the hypoperfusion cluster were less likely to achieve functional independence (adjusted odds ratio, 0.3 [95% CI, 0.1-0.9]), while patients in the hyperperfusion cluster tended to have better outcomes (adjusted odds ratio, 3.3 [95% CI, 1.3-8.8]).

conclusionsIn around half of TICI3 patients, perfusion abnormalities on the microvascular level can be observed. Microvascular hypoperfusion, despite complete macrovascular reperfusion, is rare but may explain the poor clinical course among some TICI3 patients, while a detrimental effect of hyperperfusion after reperfusion could not be confirmed.

Indexed as

Cerebrovascular CirculationEndovascular ProceduresPerfusion ImagingReperfusionAgedAged, 80 and overFemaleHumansMaleMiddle AgedRegistriesTreatment Outcomecerebrovascular circulationperfusionreperfusionstrokethrombolytic therapy

Identifiers

PMID39145382
PMCPMC11346709

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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.