Evidence map›Paper›PMID 40686305›Full record

ArticleInterventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences2025

Semi-automated tortuosity measurements confirm generalizability of IMPERATIVE trial results to real-world patients with acute ischemic stroke undergoing thrombectomy.

Maxim Mokin, William J Mack, Raul G Nogueira, Jonathan A Grossberg, Shahram Majidi, Dana Tomalty, Jan Vargas, Brett L Cucchiara, Kenneth V Snyder, Justin R Mascitelli and 21 more

Expression of concernAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It carries an expression of concern. 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.

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

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

31 authors.

Maxim MokinDepartment of Neurosurgery, Brain and Spine, University of South Florida, Tampa, FL, USA.ORCID 0000-0003-4270-8667
William J MackDepartment of Neurosurgery, Keck School of Medicine of USC, Los Angeles, CA, USA.
Raul G NogueiraDepartment of Neurology and Neurosurgery, University of Pittsburgh Medical Center, UPMC Stroke Institute, Pittsburgh, PA, USA.
Jonathan A GrossbergDepartment of Neurosurgery, Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA, USA.ORCID 0000-0002-1152-8826
Shahram MajidiDepartment of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Dana TomaltyHuntsville Hospital, Huntsville, AL, USA.
Jan VargasDepartment of Neurosurgery, Prisma Health Upstate, Greenville, SC, USA.
Brett L CucchiaraDepartment of Neurology, University of Pennsylvania, Philadelphia, PA, USA.
Kenneth V SnyderDepartment of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA.
Justin R MascitelliDepartment of Neurosurgery, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.
Victoria ParadaDepartment of Neurology, Valley Baptist Medical Center/University of Texas Rio Grande Valley, Harlingen, TX, USA.
Hakeem J ShakirDepartment of Neurosurgery, The Oklahoma University Health Sciences Center, Oklahoma City, OK, USA.ORCID 0000-0003-4234-340X
David Rosenbaum-HaleviDepartment of Neurosurgery, Munson Medical Center, Traverse City, MI, USA.
Nima AghaebrahimBaptist Neurological Institute, Lyerly Neurosurgery, Jacksonville, FL, USA.
Dan HoitDepartment of Neurosurgery, Semmes-Murphey Neurologic and Spine Institute, University of Tennessee Health Sciences Center, Memphis, TN, USA.
Benjamin YimDepartment of Neurosurgery, John Muir Health Medical Center, Walnut Creek, CA, USA.
Matthew S TenserDepartment of Neurosurgery, University of Southern California, Los Angeles, CA, USA.
Alhamza R Al-BayatiDepartment of Neurology and Neurosurgery, University of Pittsburgh Medical Center, UPMC Stroke Institute, Pittsburgh, PA, USA.ORCID 0000-0001-8103-1930
James M MilburnDepartment of Radiology, Ochsner Medical System, New Orleans, LA, USA.
Shahid M NimjeeDepartment of Neurological Surgery, Ohio State University, Columbus, OH, USA.
Neil HaranhalliDepartment of Neurological Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.
Michael NahhasDepartment of Neurology, UTHealth McGovern Medical School, Houston, TX, USA.ORCID 0000-0001-8198-7676
Darryn I ShaffDepartment of Neurointerventional Radiology, Lehigh Valley Hospital, Allentown, PA, USA.
Kennith F LaytonDepartment of Neurointerventional Radiology, Baylor University Medical Center, Dallas, TX, USA.
Narlin B BeatyDepartment of Neurosurgery Tallahassee Memorial Hospital, Tallahassee Memorial Hospital Florida State University, Tallahassee, FL, USA.
Robert M StarkeDepartment of Neurosurgery, University of Miami Health System, Miami, FL, USA.
Harris HawkDepartment of Neurosurgery, Erlanger Health System, Chattanooga, TN, USA.
Diogo C HaussenDepartment of Neurology, Emory University School of Medicine, Atlanta, GA, USA.
Aqueel PabaneyDepartment of Neurosurgery, Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA, USA.
Christopher P KellnerDepartment of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Reade A De LeacyDepartment of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA.

Funding

Einstein-Montefiore Clinical and Translational Science Award HubUM1TR004400 · NCATS · ALBERT EINSTEIN COLLEGE OF MEDICINE · PI Jessica Kahn, Mimi Y Kim · 2023 to 2026
$17.3M
NCATS NIH HHS UM1 TR004400
6 · The paper itself

Abstract

BackgroundCriticism of clinical trials of endovascular therapy of acute ischemic stroke due to large vessel occlusion includes their lack of generalizability. We aimed to evaluate the impact of vessel tortuosity on the outcomes of large-bore and super-bore aspiration catheters in the Imperative Trial and to compare trial's selection of patients to a real-world setting.MethodsUsing baseline craniocervical angiography, we performed semi-automated analysis of various tortuosity characteristics. Comparison of tortuosity characteristics was made to a previously published cohort of 100 consecutive patients treated with thrombectomy (real-world cohort).ResultsOf the 249 Imperative Trial patients with anterior circulation strokes, 187 (89%) had complete tortuosity assessments from the aortic arch to the occlusion site. Tortuosity indexes for the common carotid, extracranial and intracranial internal carotid artery segments were similar for both cohorts (right side 0.18 ± 0.10, 0.17 ± 0.09, 0.45 ± 0.09 vs. 0.20 ± 0.09, 0.17 ± 0.09, 0.45 ± 0.09; left side: 0.12 ± 0.08, 0.19 ± 0.09, 0.44 ± 0.07 vs. 0.15 ± 0.08, 0.18 ± 0.08, 0.47 ± 0.07 in the Imperative Trial and in the real-world cohort, respectively). The proportion of patients with type 3 aortic arches was higher in the Imperative Trial than the real-word cohort (26% vs. 15%,

Indexed as

aspirationCTAStrokethrombectomytortuosity

Identifiers

PMID40686305
PMCPMC12279764

What OpenQuestion holds

Textmetadata
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Registered trials

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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.