Evidence map›Paper›PMID 40436255›Full record

Observational studyJournal of stroke and cerebrovascular diseases : the official journal of National Stroke Association2025

Hyperemia detection on arterial spin labeling is associated with final infarct volume in stroke post-endovascular therapy.

Carolyn A Lomahan, Marie Luby, Georgios Kalarakis, Amie W Hsia, John K Lynch, Karan P Nathani, Sana Somani, Leila C Thomas, Fabian Arnberg-Sandor, Lawrence L Latour

Registry-linked trialAbstract readComparative StudyMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00009243 (Evaluation, Pathogenesis, and Treatment of Patients With or at Risk for Cerebrovascular Disease), which is not on this map. Not yet cited in PubMed.

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

NCT00009243 recruitingnot on this map

Evaluation, Pathogenesis, and Treatment of Patients With or at Risk for Cerebrovascular Disease (A Natural History/Disease Pathogenesis Protocol)

TypeobservationalSponsorNational Institute of Neurological Disorders and Stroke (NINDS)Ran2001Enrolled4,000ConditionsBrain Disease, Ischemic Attack, Transient, Cerebrovascular Accident, Cerebrovascular Disorder
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

10 authors.

Carolyn A LomahanAcute Cerebrovascular Diagnostics Unit - Stroke Branch, National Institute of Neurological Disorders and Stroke, Bethesda, MD, USA; Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
Marie LubyAcute Cerebrovascular Diagnostics Unit - Stroke Branch, National Institute of Neurological Disorders and Stroke, Bethesda, MD, USA.
Georgios KalarakisDepartment of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Department of Neuroradiology, Karolinska University Hospital, Stockholm, Sweden.
Amie W HsiaAcute Cerebrovascular Diagnostics Unit - Stroke Branch, National Institute of Neurological Disorders and Stroke, Bethesda, MD, USA; Medstar Washington Hospital Center Comprehensive Stroke Center, Washington DC, USA.
John K LynchAcute Cerebrovascular Diagnostics Unit - Stroke Branch, National Institute of Neurological Disorders and Stroke, Bethesda, MD, USA.
Karan P NathaniAcute Cerebrovascular Diagnostics Unit - Stroke Branch, National Institute of Neurological Disorders and Stroke, Bethesda, MD, USA; Johns Hopkins Medicine, Suburban Hospital, Bethesda, MD, USA.
Sana SomaniAcute Cerebrovascular Diagnostics Unit - Stroke Branch, National Institute of Neurological Disorders and Stroke, Bethesda, MD, USA; Medstar Washington Hospital Center Comprehensive Stroke Center, Washington DC, USA.
Leila C ThomasAcute Cerebrovascular Diagnostics Unit - Stroke Branch, National Institute of Neurological Disorders and Stroke, Bethesda, MD, USA; Johns Hopkins Medicine, Suburban Hospital, Bethesda, MD, USA.
Fabian Arnberg-SandorDepartment of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Department of Neuroradiology, Karolinska University Hospital, Stockholm, Sweden.
Lawrence L LatourAcute Cerebrovascular Diagnostics Unit - Stroke Branch, National Institute of Neurological Disorders and Stroke, Bethesda, MD, USA. Electronic address: latourl@ninds.nih.gov.

Funding

CLINICAL AND IMAGING CORE SUPPORT OF ACUTE STROKE RESEARCHZICNS003044 · NINDS · NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE · PI LATOUR, LAWRENCE · 2015 to 2025
$32.8M
NOVEL INSIGHTS INTO CEREBRAL ISCHEMIC PATHOPHYSIOLOGY IN HUMANSZIANS003043 · NINDS · NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE · PI LATOUR, LAWRENCE · 2009 to 2025
$19.5M
Intramural NIH HHS ZIA NS003043Intramural NIH HHS ZIC NS003044
6 · The paper itself

Abstract

background and purposePatients with acute ischemic stroke (AIS) treated with endovascular therapy (EVT) may develop hyperemia due to loss of relative cerebral blood flow (rCBF) autoregulation. Hyperemia can be detected on two types of MRI perfusion weighted imaging: dynamic susceptibility contrast (DSC) and arterial spin labeling (ASL). The aim of this study was to compare hyperemia on ASL-rCBF to DSC-rCBF post-EVT and explore the association between hyperemia and final infarct volume (FIV).

methodsThis is a retrospective analysis of the GUARDS cohort in the ongoing prospective Natural History of Stroke study (ClinicalTrials.gov Identifier: NCT00009243). Patients with AIS who met the following criteria were eligible for this analysis: (i) ≥ 18 years, (ii) no contraindication to 3T MRI, (iii) large vessel occlusion in the anterior circulation, (iv) attempted EVT, and (v) 3T MRI obtained at 24 hours, including DSC-rCBF and ASL-rCBF, and at 5 days post-EVT. Qualitative imaging analysis for hyperemia detection was performed by consensus between two independent raters. Quantitative imaging analysis assessed hyperemic tissue volume, FIV, and Dice coefficients between hyperemia and FIV masks.

resultsForty patients with median (IQR) age of 70 (62-81) years and admission NIHSS 16 (10-21) were included. Hyperemia was identified on ASL-rCBF in 40 % (16) of patients and on DSC-rCBF in 30 % (12). For 9 patients with hyperemia on both modalities, the ASL-rCBF and DSC-rCBF median volumes were 85.7 (19.4-144.9) and 58.1 (26.2-74.0) (p = 0.10). The Dice coefficient for hyperemia on ASL-rCBF and FIV was higher compared to DSC-rCBF, 0.60 (0.54-0.69) versus 0.39 (0.34-0.49).

conclusionHyperemia volumes measured on ASL-rCBF, compared to DSC-rCBF, at 24 hours were more associated with FIV at 5 days. Hyperemia may be an indicator of impaired cerebral autoregulation and potential target for adjunctive therapy to mitigate infarct growth.

Indexed as

Cerebrovascular CirculationEndovascular ProceduresHyperemiaIschemic StrokeMagnetic Resonance AngiographyMagnetic Resonance ImagingPerfusion ImagingSpin LabelsAgedAged, 80 and overFemaleHumansMaleMiddle AgedPredictive Value of TestsRetrospective StudiesSpin LabelsArterial spin labelingCerebral autoregulationCerebral blood flowFinal infarct volumeHyperemiaReperfusion injury

Identifiers

PMID40436255
PMCPMC12276909

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Registered trials

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.