Evidence map›Paper›PMID 39551878›Full record

ArticleClinical neuroradiology2025

Mismatch Vs No Mismatch in Large Core-A Matter of Definition.

Vivek Yedavalli, Hamza Adel Salim, Dhairya A Lakhani, Janet Mei, Aneri Balar, Basel Musmar, Nimer Adeeb, Meisam Hoseinyazdi, Licia Luna, Francis Deng and 13 more

Abstract read
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In one paragraph

Article in Clinical neuroradiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing 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

9 citing papers in PubMed.

  1. Article
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  8. Article
  9. 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
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

23 authors.

Vivek YedavalliDepartment of Radiology, Division of Neuroradiology, Johns Hopkins Medical Center, Phipps B112-D, 21287, Baltimore, MD, USA. Vyedava1@jhmi.edu.
Hamza Adel SalimDepartment of Radiology, Division of Neuroradiology, Johns Hopkins Medical Center, Phipps B112-D, 21287, Baltimore, MD, USA. Hamza.sleeem@gmail.com.
Dhairya A LakhaniDepartment of Radiology, Division of Neuroradiology, Johns Hopkins Medical Center, Phipps B112-D, 21287, Baltimore, MD, USA.
Janet MeiDepartment of Radiology, Division of Neuroradiology, Johns Hopkins Medical Center, Phipps B112-D, 21287, Baltimore, MD, USA.
Aneri BalarDepartment of Radiology, Division of Neuroradiology, Johns Hopkins Medical Center, Phipps B112-D, 21287, Baltimore, MD, USA.
Basel MusmarDepartment of Neurosurgery and Interventional Neuroradiology, Louisiana State University, Baton Rouge, LA, USA.
Nimer AdeebDepartment of Neurosurgery and Interventional Neuroradiology, Louisiana State University, Baton Rouge, LA, USA.
Meisam HoseinyazdiDepartment of Radiology, Division of Neuroradiology, Johns Hopkins Medical Center, Phipps B112-D, 21287, Baltimore, MD, USA.
Licia LunaDepartment of Radiology, Division of Neuroradiology, Johns Hopkins Medical Center, Phipps B112-D, 21287, Baltimore, MD, USA.
Francis DengDepartment of Radiology, Division of Neuroradiology, Johns Hopkins Medical Center, Phipps B112-D, 21287, Baltimore, MD, USA.
Nathan Z HysonDepartment of Radiology, Division of Neuroradiology, Johns Hopkins Medical Center, Phipps B112-D, 21287, Baltimore, MD, USA.
Adam A DmytriwNeuroendovascular Program, Massachusetts General Hospital, Harvard University, Boston, MA, USA.
Adrien GuenegoDepartment of Diagnostic and Interventional Neuroradiology, Erasme University Hospital, Brussels, Belgium.
Hanzhang LuDepartment of Radiology, Division of Neuroradiology, Johns Hopkins Medical Center, Phipps B112-D, 21287, Baltimore, MD, USA.
Victor C UrrutiaDepartment of Radiology, Division of Neuroradiology, Johns Hopkins Medical Center, Phipps B112-D, 21287, Baltimore, MD, USA.
Kambiz NaelDepartment of Radiology & Biomedical Imaging, University of California, San Francisco, CA, USA.
Elisabeth B MarshDepartment of Radiology, Division of Neuroradiology, Johns Hopkins Medical Center, Phipps B112-D, 21287, Baltimore, MD, USA.
Raf LlinasDepartment of Radiology, Division of Neuroradiology, Johns Hopkins Medical Center, Phipps B112-D, 21287, Baltimore, MD, USA.
Argye E HillisDepartment of Radiology, Division of Neuroradiology, Johns Hopkins Medical Center, Phipps B112-D, 21287, Baltimore, MD, USA.
Max WintermarkDepartment of Neuroradiology, MD Anderson Medical Center, 77030, Houston, TX, USA.
Tobias D FaizyDepartment of Radiology, Neuroendovascular Program, University Medical Center Münster, Münster, Germany.
Jeremy J HeitDepartment of Interventional Neuroradiology, Stanford Medical Center, Palo Alto, CA, USA.
Gregory W AlbersDepartment of Interventional Neuroradiology, Stanford Medical Center, Palo Alto, CA, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEndovascular thrombectomy (EVT) has shown promise in randomized controlled trials (RCTs) for large ischemic core stroke patients, yet variability in core definition and onset-to-imaging time creates heterogeneity in outcomes. This study aims to clarify the prevalence and implications of core-perfusion mismatch (MM) versus no mismatch (No MM) in such patients, utilizing established imaging criteria.

methodsA retrospective cohort study was conducted including patients from 7/29/2019 to 1/29/2023, with data extracted from a continuously maintained database. Patients were eligible if they met criteria including multimodal CT imaging performed within 24 h from last known well (LKW), AIS-LVO diagnosis, and ischemic core size defined by specific rCBF thresholds. Mismatch was assessed based on different operational definitions from the EXTEND and DEFUSE 3 trials.

resultsFifty-two patients were included, with various time windows from LKW. Using EXTEND criteria, a significant portion of early window patients exhibited MM; however, fewer patients met MM criteria in the late window. Defining MM using DEFUSE 3 criteria yielded similar patterns, but with overall lower MM prevalence in the late window. When employing rCBF <38% as a surrogate for ischemic core, a higher percentage of patients were classified as MM across both time windows compared to rCBF <30%.

conclusionThe prevalence of MM in large ischemic core patients varies significantly depending on the imaging criteria and time from LKW. Notably, MM was more prevalent in the early time window across all criteria used. Additional RCTs are needed to determine if this definition of MM identifies patients who will benefit most from EVT.

Indexed as

Endovascular ProceduresIschemic StrokeThrombectomyAgedFemaleHumansMaleMiddle AgedRetrospective StudiesTomography, X-Ray ComputedCTPLarge coreMismatchPenumbraStroke

Identifiers

PMID39551878

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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.