Evidence map›Paper›PMID 40627189›Full record

SynthesisNeuroradiology2025

Prognostic value of cerebral venous outflow profiles for outcomes prediction following reperfusion therapy in acute ischemic stroke: a meta-analysis.

Hesham Kelani, Mohamed R Abdelraouf, Shree Rath, Shrouk F Mohamed, Hazem Mohamed Salamah, Qasim Mehmood, Muhammad Ansab, Danisha Kumar, Ahmed Abd Elazim, Diana Greene-Chandos and 5 more

Abstract readMeta-AnalysisReview
In one paragraph

Synthesis in Neuroradiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. 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

15 authors.

Hesham KelaniNeurology Department, SUNY Downstate Health Sciences University at One Brooklyn Health, Brooklyn, NY, USA. Hesham.Kelani@Downstate.edu.
Mohamed R AbdelraoufFaculty of Medicine, Alexandria University, Alexandria, Egypt. mohamedramadan14728@gmail.com.
Shree RathAll India Institute of Medical Sciences, Bhubaneswar, India.
Shrouk F MohamedFaculty of Medicine, Alexandria University, Alexandria, Egypt.
Hazem Mohamed SalamahFaculty of Medicine, Zagazig University, Zagazig, Egypt.
Qasim MehmoodKing Edward Medical University, Lahore, Pakistan.
Muhammad AnsabServices Institute of Medical Sciences, Lahore, Pakistan.
Danisha KumarDow University of Health Sciences, Karachi, Pakistan.
Ahmed Abd ElazimDepartment of Neurology, Sanford USD Medical center, Sioux Falls, SD, USA.
Diana Greene-ChandosDepartment of Neurology, School of Medicine, University of Saint Louis, Saint Louis, MO, USA.
Ketevan BerekashviliDepartment of Neurology, Mohawk Valley Health System, Utica, NY, USA.
Ambooj TiwariChief of Neurology, South Brooklyn Health, Clinical Assistant Professor YNU Grossman School of Medicine, New York, NY, USA.
Volodymyr VulkanovDepartment of Neurology, Rutgers New Jersey School of Medicine, Newark, NJ, USA.
David P LernerNeurology Department, SUNY Downstate Health Sciences University at One Brooklyn Health, Brooklyn, NY, USA.
Eytan RazDepartment of Neurosurgery, NYU Langone, New York, NY, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRecent studies have suggested that favorable venous outflow (VO) may be a promising imaging biomarker to predict clinical outcomes following reperfusion therapy in patients with acute ischemic stroke caused by large vessel occlusion (AIS-LVO).

methodsA comprehensive literature search was conducted in PubMed, Scopus, WOS, and Cochrane to identify studies that evaluated VO profiles, assessed using the Cortical Vein Opacification Score (COVES). The risk ratio (RR) and 95% confidence interval (CI) for the outcomes, including functional independence, assessed by modified rankin scale at 90 days (mRS 0-2), hemorrhagic infarction, parenchymal hematoma, 90-day mortality, intracranial hemorrhage (ICH), and symptomatic ICH (sICH), were calculated and analyzed using the 'meta' package in R version 4.4.1.

resultsA total of six studies encompassing 2249 patients were included. Patients with favorable VO had a higher likelihood of achieving functional independence at 90 days (RR = 2.15; 95% CI: 1.35, 3.42; p = 0.01) and a lower incidence of 90-day mortality (RR = 0.39; 95% CI: 0.30, 0.51; p < 0.01), parenchymal hematoma (RR = 0.36; 95% CI: 0.27, 0.47; p < 0.01). Furthermore, sICH was less frequent in patients with favorable VO (RR = 0.39; 95% CI: 0.17, 0.89; p = 0.03). However, hemorrhagic infarction and any ICH did not differ significantly between the two groups (p-values: 0.06 and 0.32, respectively).

conclusionVO is a promising imaging biomarker for predicting outcomes in patients with AIS-LVO following reperfusion therapy. Prospective clinical trials are warranted to investigate the predictive value of VO, assessed on multiphasic computed tomography angiography (CTA), as a prognostic marker in this patient population.

Indexed as

Cerebral VeinsIschemic StrokeReperfusionHumansPredictive Value of TestsPrognosisTreatment OutcomeAcute ischemic strokeBiomarkerCOVESIntracranial hemorrhageReperfusion therapyThrombectomyVenous outflow

Identifiers

PMID40627189
PMCPMC12546523

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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.