ArticleAnnals of clinical and translational neurology2025
Prolonged venous transit is associated with worse neurological recovery in successfully reperfused large vessel strokes.
Article in Annals of clinical and translational neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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Who cites it
17 citing papers in PubMed.
- Quantitative assessment of cerebral venous outflow on routine CT angiography in acute ischemic stroke.European radiology · 2026Article
- Tmax 10 Volume Is Independently Associated with NWU Delta in Large Core Stroke.Clinical neuroradiology · 2026Observational
- Baseline prolonged venous transit on CT perfusion predicts the post-treatment Brush Sign after successful reperfusion in acute ischemic stroke patients.Frontiers in neurology · 2026Article
- Clinical outcomes of patients with unsuccessful mechanical thrombectomy versus best medical management of medium vessel occlusion stroke in the middle cerebral artery territory.Journal of neurointerventional surgery · 2025Article
- Prolonged venous transit and clinical outcomes in anterior circulation large-vessel occlusion stroke with complete or near-complete reperfusion.Neuroradiology · 2025Article
- Unfavorable Perfusion Collateral Impairment Score Is Associated with Higher Odds of Poor Outcomes in Large Vessel Occlusion Stroke.Stroke (Hoboken, N.J.) · 2025Article
- Prolonged venous transit - where venous outflow meets financial outflow: a cost analysis.Neuroradiology · 2025Article
- Interobserver and Intraobserver Variability in the Assessment of Prolonged Venous Transit in Anterior Circulation Large-Vessel Occlusion Ischemic Stroke.AJNR. American journal of neuroradiology · 2025Article
- Prolonged Venous Transit Independently Predicts Worse Functional Outcomes at Discharge in Successfully Reperfused Patients with Large Vessel Occlusion Stroke.Clinical neuroradiology · 2025Article
- Integrating perfusion imaging derived venous outflow and tissue-level collateral parameters in a comprehensive clinical model enhances prognostication in large vessel occlusion stroke.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2025Article
- The Cortical Vein Opacification Score Is Independently Associated with Good and Excellent Functional Outcomes at 90 Days in Patients with Minor Stroke with Anterior Circulation Large-Vessel Occlusion: A Multicenter Study.AJNR. American journal of neuroradiology · 2025Article
- Efficacy and safety of mechanical thrombectomy in distal medium middle cerebral artery occlusion ischemic stroke patients on low-dose aspirin.International journal of stroke : official journal of the International Stroke Society · 2025Article
- 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 · 2025Article
- Prolonged Venous Transit as a Superior Predictor of Functional Outcomes in Successfully Reperfused Large Vessel Occlusions: Comparative Analysis With Cerebral Blood Volume Index and Hypoperfusion Intensity Ratio.Journal of the American Heart Association · 2025Article
- Venous outflow time profiles: promising imaging biomarkers for futile recanalization in acute ischemic stroke due to large vessel occlusion.Frontiers in neurology · 2025Article
- Volume contracted state, mortality and functional outcomes in patients with acute ischaemic stroke due to large vessel occlusion.BMJ neurology open · 2025Article
- 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 NeuroimagingArticle
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27 authors.
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Abstract
objectiveVenous outflow (VO) impairment predicts unfavorable outcomes in patients with acute ischemic stroke caused by large vessel occlusion (AIS-LVO). Prolonged venous transit (PVT), a visual qualitative VO marker on CT perfusion (CTP) time to maximum (Tmax) maps, has been associated with unfavorable 90-day functional outcomes despite successful reperfusion. This study investigates the association between PVT and percent change on the National Institutes of Health Stroke Scale (NIHSS) among AIS-LVO patients who have undergone successful reperfusion.
methodsWe performed a retrospective analysis of prospectively collected data from consecutive adult AIS-LVO patients with successful reperfusion (modified Thrombolysis in Cerebral Infarction 2b/2c/3). PVT+ was defined as Tmax ≥10 s in the superior sagittal sinus, torcula, or both. The primary outcome was continuous NIHSS percent change and dichotomous NIHSS percent change ≥70%. Regression analyses were performed to assess the effect of PVT on NIHSS percent change.
resultsIn 119 patients of median (IQR) age 71 (63-81) years, the admission and discharge NIHSS scores were significantly higher in PVT+ patients compared to PVT- patients (17 [14-23.5] vs. 13 [9.5-19], p = 0.011, and 7.5 [4-12] vs. 3 [1-7], p < 0.001, respectively). After adjusting for age, sex, hypertension, diabetes, atrial fibrillation, administration of intravenous thrombolysis (IVT), Alberta Stroke Program Early CT Scores (ASPECTS), mTICI 2c and/or 3, Tmax >6 s volume, and hemorrhagic transformation, PVT+ was significantly associated with lower NIHSS percent change (B = -0.163, 95%CI -0.326 to -0.001, p = 0.049) and was less likely to achieve higher than 70% NIHSS improvement (OR = 0.331, 95% CI 0.127-0.863, p = 0.024).
interpretationPVT+ was significantly associated with reduced neurological improvement despite successful reperfusion in AIS-LVO patients, highlighting the critical role of VO impairment in short-term functional outcomes. These findings further validate PVT as a valuable adjunct imaging biomarker derived from CTP for assessing VO profiles in AIS-LVO.
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