Evidence map›Paper›PMID 39477546›Full record

ReviewAJNR. American journal of neuroradiology2025

Role of Hypoperfusion Intensity Ratio in Vessel Occlusions: A Review on Safety and Clinical Outcomes.

Sana Rehman, Arsalan Nadeem, Arbab Burhan Uddin Kasi, Ali Husnain, Summaiyya Waseem, Sohail Kumar, Syed Muhammad Owais, Nasreen Banu, Dhairya A Lakhani, Hamza A Salim and 15 more

Abstract readReview
In one paragraph

Review in AJNR. American journal of neuroradiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.

0numbers the graph read from it
0cells of the map it votes in
16citing 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

16 citing papers in PubMed.

  1. Observational
  2. Article
  3. Article
  4. Cytoprotection Concepts for Ischemic Stroke in the Recanalization Era.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2026
    Review
  5. Article
  6. Article
  7. Article
  8. Hypoperfusion intensity ratio is associated with follow-up infarct volume in medium vessel occlusions: A multicenter multinational study.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2025
    Article
  9. Article
  10. Article
  11. Article
  12. Efficacy of intravenous thrombolysis in patients with mild acute ischemic stroke and large vessel occlusion with different hypoperfusion volumes.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025
    Article
  13. Perfusion imaging parameters predict long-term clinical outcome in isolated posterior cerebral artery occlusion stroke patients.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2025
    Article
  14. Advances in Collateral Neuroimaging for Acute Ischemic Stroke: Redefining Time and Tissue Windows in the Reperfusion Era.Journal of neuroimaging : official journal of the American Society of Neuroimaging
    Review
  15. Prolonged Venous Transit Is Associated With Unfavorable Outcomes in Anterior Circulation Distal Medium Vessel Stroke.Journal of neuroimaging : official journal of the American Society of Neuroimaging
    Article
  16. 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

25 authors.

Sana RehmanFrom the Department of Radiology and Radiological Sciences (S.R., D.A.L., H.A.S., R.X., A.E.H., V.C.U., R.H.L., E.B.M., H.L., G.W.A., V.S.Y.), Johns Hopkins University, Baltimore, Maryland.
Arsalan NadeemDepartment of Medicine (A.N.), Allama Iqbal Medical College, Lahore, Pakistan.ORCID 0000-0002-6724-2042
Arbab Burhan Uddin KasiMass General Brigham (A.B.U.K.), Boston, Massachusetts.ORCID 0000-0001-8849-5535
Ali HusnainDivision of Interventional Radiology, Department of Radiology, Section of Interventional Radiology (A.H.), Northwestern Memorial Hospital, Chicago, Illinois.
Summaiyya WaseemDow University of Health Sciences (S.W.), Karachi, Pakistan.
Sohail KumarHMH JFK University Medical Center (S.K.), Edison, New Jersey.
Syed Muhammad OwaisUniversity of Toledo (S.M.O.), Toledo, Ohio.
Nasreen BanuShadan Institute of Medical Sciences (N.B.), Hyderabad, Telangana, India.
Dhairya A LakhaniFrom the Department of Radiology and Radiological Sciences (S.R., D.A.L., H.A.S., R.X., A.E.H., V.C.U., R.H.L., E.B.M., H.L., G.W.A., V.S.Y.), Johns Hopkins University, Baltimore, Maryland.ORCID 0000-0001-7577-1887
Hamza A SalimFrom the Department of Radiology and Radiological Sciences (S.R., D.A.L., H.A.S., R.X., A.E.H., V.C.U., R.H.L., E.B.M., H.L., G.W.A., V.S.Y.), Johns Hopkins University, Baltimore, Maryland.ORCID 0000-0002-5208-8425
Risheng XuFrom the Department of Radiology and Radiological Sciences (S.R., D.A.L., H.A.S., R.X., A.E.H., V.C.U., R.H.L., E.B.M., H.L., G.W.A., V.S.Y.), Johns Hopkins University, Baltimore, Maryland.
Vaibhav S VagalStony Brook University Renaissance School of Medicine (V.S.V.), New York, New York.
Yasmin N AzizUniversity of Cincinnati College of Medicine (Y.N.A.), Cincinnati, Ohio.
Argye E HillisFrom the Department of Radiology and Radiological Sciences (S.R., D.A.L., H.A.S., R.X., A.E.H., V.C.U., R.H.L., E.B.M., H.L., G.W.A., V.S.Y.), Johns Hopkins University, Baltimore, Maryland.
Victor C UrrutiaFrom the Department of Radiology and Radiological Sciences (S.R., D.A.L., H.A.S., R.X., A.E.H., V.C.U., R.H.L., E.B.M., H.L., G.W.A., V.S.Y.), Johns Hopkins University, Baltimore, Maryland.ORCID 0000-0002-4995-6949
Rafael H LlinasFrom the Department of Radiology and Radiological Sciences (S.R., D.A.L., H.A.S., R.X., A.E.H., V.C.U., R.H.L., E.B.M., H.L., G.W.A., V.S.Y.), Johns Hopkins University, Baltimore, Maryland.
Elisabeth B MarshFrom the Department of Radiology and Radiological Sciences (S.R., D.A.L., H.A.S., R.X., A.E.H., V.C.U., R.H.L., E.B.M., H.L., G.W.A., V.S.Y.), Johns Hopkins University, Baltimore, Maryland.ORCID 0000-0002-2385-5074
Richard LeighDepartment of Neurology (R.L.), Johns Hopkins Medicine, Baltimore, Maryland.ORCID 0000-0002-8285-1815
Hanzhang LuFrom the Department of Radiology and Radiological Sciences (S.R., D.A.L., H.A.S., R.X., A.E.H., V.C.U., R.H.L., E.B.M., H.L., G.W.A., V.S.Y.), Johns Hopkins University, Baltimore, Maryland.ORCID 0000-0003-3871-1564
Adam A DmytriwNeuroendovascular Program (A.A.D.), Massachusetts General Hospital, Boston, Massachusetts.ORCID 0000-0003-0131-5699
Adrien GuenegoDepartment of Diagnostic and Interventional Neuroradiology (A.G.), Erasme University Hospital, Brussels, Belgium.ORCID 0000-0001-7281-1652
Gregory W AlbersFrom the Department of Radiology and Radiological Sciences (S.R., D.A.L., H.A.S., R.X., A.E.H., V.C.U., R.H.L., E.B.M., H.L., G.W.A., V.S.Y.), Johns Hopkins University, Baltimore, Maryland.
Jeremy J HeitDepartment of Neurology (G.W.A., J.J.H.), Stanford University, Stanford, California.ORCID 0000-0003-1055-8000
Tobias D FaizyDepartment of Radiology, Neuroendovascular Program (T.D.F.), University Medical Center Münster, Munster, Germany.ORCID 0000-0002-1631-2020
Vivek S YedavalliFrom the Department of Radiology and Radiological Sciences (S.R., D.A.L., H.A.S., R.X., A.E.H., V.C.U., R.H.L., E.B.M., H.L., G.W.A., V.S.Y.), Johns Hopkins University, Baltimore, Maryland vyedava1@jhmi.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The hypoperfusion intensity ratio (HIR) is a quantitative metric used in vascular occlusion imaging to evaluate the extent of brain tissue at risk due to hypoperfusion. Defined as the ratio of tissue volume with a time-to-maximum (Tmax) of >10 seconds to that of >6 seconds, HIR assists in differentiating between the salvageable penumbra and the irreversibly injured core infarct. This review explores the role of HIR in assessing clinical outcomes and guiding treatment strategies, including mechanical thrombectomy and thrombolytic therapy, for patients with large-vessel occlusions (LVOs). Evidence suggests that higher HIR values are associated with worse clinical outcomes, indicating more severe tissue damage and reduced potential for salvage through reperfusion. Additionally, HIR demonstrates predictive accuracy regarding infarct growth, collateral flow, and the risk of reperfusion hemorrhage. It has shown superiority over traditional metrics, such as core infarct volume, in predicting functional outcomes. HIR offers valuable insights for risk stratification and treatment planning in patients with LVOs and distal medium vessel occlusions. Incorporating HIR into clinical practice enhances patient care by improving decision-making processes, promoting timely interventions, and optimizing postintervention management to minimize complications and improve recovery outcomes.

Indexed as

Cerebrovascular CirculationHumansTreatment Outcome

Identifiers

PMID39477546
PMCPMC12152793

What OpenQuestion holds

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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.