Evidence map›Paper›PMID 39979027›Full record

ArticleAJNR. American journal of neuroradiology2025

Hypoperfusion Intensity Ratio Less Than 0.4 Is Associated with Favorable Outcomes in Unsuccessfully Reperfused Acute Ischemic Stroke with Large-Vessel Occlusion.

Vivek Yedavalli, Hamza Adel Salim, Aneri Balar, Dhairya A Lakhani, Janet Mei, Hanzhang Lu, Licia Luna, Francis Deng, Vaibhav Vagal, Nathan Z Hyson and 8 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article 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 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing 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

4 citing papers in PubMed.

  1. Article
  2. Association of hypoperfusion intensity ratio and cerebral blood volume Index with good outcome in patients transferred for thrombectomy.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2025
    Article
  3. 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
  4. 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

18 authors.

Vivek YedavalliFrom the Department of Radiology, Division of Neuroradiology (V.Y., H.A.S., J.M., H.L., L.L., F.D., N.Z.H.), Johns Hopkins Medical Center, Baltimore, Maryland Vyedava1@jhmi.edu.
Hamza Adel SalimDepartment of Neuroradiology (H.A.S., M.W.), The University of Texas MD Anderson Center, Houston, Texas.ORCID 0000-0002-5208-8425
Aneri BalarDepartment of Radiology, Division of Neuroradiology (A.B., D.A.L.), West Virginia University, Morgantown, WV, USA.
Dhairya A LakhaniDepartment of Radiology, Division of Neuroradiology (A.B., D.A.L.), West Virginia University, Morgantown, WV, USA.ORCID 0000-0001-7577-1887
Janet MeiFrom the Department of Radiology, Division of Neuroradiology (V.Y., H.A.S., J.M., H.L., L.L., F.D., N.Z.H.), Johns Hopkins Medical Center, Baltimore, Maryland.
Hanzhang LuFrom the Department of Radiology, Division of Neuroradiology (V.Y., H.A.S., J.M., H.L., L.L., F.D., N.Z.H.), Johns Hopkins Medical Center, Baltimore, Maryland.ORCID 0000-0003-3871-1564
Licia LunaFrom the Department of Radiology, Division of Neuroradiology (V.Y., H.A.S., J.M., H.L., L.L., F.D., N.Z.H.), Johns Hopkins Medical Center, Baltimore, Maryland.ORCID 0000-0003-3539-4831
Francis DengFrom the Department of Radiology, Division of Neuroradiology (V.Y., H.A.S., J.M., H.L., L.L., F.D., N.Z.H.), Johns Hopkins Medical Center, Baltimore, Maryland.ORCID 0000-0003-3117-5076
Vaibhav VagalRenaissance School of Medicine at Stony Brook University (V.V.), Stony Brook, New York.
Nathan Z HysonFrom the Department of Radiology, Division of Neuroradiology (V.Y., H.A.S., J.M., H.L., L.L., F.D., N.Z.H.), Johns Hopkins Medical Center, Baltimore, Maryland.
Jens FiehlerDepartment of Radiology (J.F., G.B., C.H.), Neuroendovascular Program, University Medical Center Hamburg, Hamburg, Germany.ORCID 0000-0001-8533-7478
Paul StrackeDepartment of Radiology (P.S., T.D.F.), Neuroendovascular Program, University Medical Center Münster, Münster, Germany.
Gabriel BroocksDepartment of Radiology (J.F., G.B., C.H.), Neuroendovascular Program, University Medical Center Hamburg, Hamburg, Germany.ORCID 0000-0002-7575-9850
Christian HeitkampDepartment of Radiology (J.F., G.B., C.H.), Neuroendovascular Program, University Medical Center Hamburg, Hamburg, Germany.ORCID 0000-0002-8988-0918
Gregory W AlbersDepartment of Interventional Neuroradiology (G.W.A., J.J.H.), Stanford Medical Center, Palo Alto, California.
Max WintermarkDepartment of Neuroradiology (H.A.S., M.W.), The University of Texas MD Anderson Center, Houston, Texas.ORCID 0000-0002-6726-3951
Tobias D FaizyDepartment of Radiology (P.S., T.D.F.), Neuroendovascular Program, University Medical Center Münster, Münster, Germany.ORCID 0000-0002-1631-2020
Jeremy J HeitDepartment of Interventional Neuroradiology (G.W.A., J.J.H.), Stanford Medical Center, Palo Alto, California.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

background and purposeEndovascular thrombectomy is a standard treatment for acute ischemic stroke due to large-vessel occlusions (AIS-LVO), but a large minority of patients do not achieve successful reperfusion. This study aimed to investigate the hypoperfusion intensity ratio (HIR) as a prognostic biomarker in unsuccessfully reperfused patients with AIS-LVO. MATERIALS AND

methodsA multicenter retrospective cohort study was conducted at 2 comprehensive stroke centers, involving patients with AIS-LVO who underwent endovascular thrombectomy but did not achieve successful reperfusion, defined as a modified TICI score of 0-2a. HIR, derived from CT or MR perfusion imaging, was analyzed for its association with favorable clinical outcomes (90-day mRs score of 0-2). The optimal HIR threshold predictive of favorable outcomes was identified through receiver operating curve analysis.

resultsOf 129 patients included, 20 (15.5%) achieved favorable outcomes. HIR of <0.4 significantly predicted favorable outcomes with a sensitivity of 66% and specificity of 80%. Patients with an HIR of <0.4 demonstrated better clinical and imaging profiles, including lower admission NIHSS scores and smaller ischemic core volumes. Multivariable logistic regression confirmed HIR, along with age and the presence of hemorrhagic transformation, as independent predictors of favorable outcomes.

conclusionsIn unsuccessfully reperfused patients with AIS-LVO, an HIR of <0.4 is associated with favorable outcomes, emphasizing on the importance of robust collateral circulation. This finding suggests that perfusion imaging and HIR evaluation could guide clinical decision-making and prognostication in this challenging patient subset.

Indexed as

Ischemic StrokeThrombectomyAgedAged, 80 and overEndovascular ProceduresFemaleHumansMaleMiddle AgedPrognosisReperfusionRetrospective StudiesTomography, X-Ray ComputedTreatment Outcome

Identifiers

PMID39979027
PMCPMC11979814

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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.