Evidence map›Paper›PMID 40829981›Full record

ArticleNeurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics2025

Hypoperfusion intensity ratio is associated with follow-up infarct volume in medium vessel occlusions: A multicenter multinational study.

Vivek Yedavalli, Hamza Adel Salim, Dhairya Lakhani, Basel Musmar, Nimer Adeeb, Davide Simonato, Yan-Lin Li, Orabi Hajjeh, Muhammed Amir Essibayi, Nils Henninger and 54 more

Abstract readMulticenter Study
In one paragraph

Article in Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing 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

3 citing papers in PubMed.

  1. Article
  2. Article
  3. 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

64 authors.

Vivek YedavalliDepartment of Radiology, Division of Neuroradiology, Johns Hopkins Medical Center, Baltimore, MD, USA. Electronic address: vyedava1@jhmi.edu.
Hamza Adel SalimDepartment of Radiology, Division of Neuroradiology, Johns Hopkins Medical Center, Baltimore, MD, USA; Department of Neuroradiology, MD Anderson Medical Center, Houston, TX 77030, USA. Electronic address: Hamza.sleeem@gmail.com.
Dhairya LakhaniDepartment of Radiology, Division of Neuroradiology, Johns Hopkins Medical Center, Baltimore, MD, USA; Department of Neuroradiology, Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV 26505, USA.
Basel MusmarDepartment of Neurosurgery, Thomas Jefferson University, Philadelphia, PA, USA.
Nimer AdeebDepartment of Neurosurgery and Interventional Neuroradiology, Louisiana State University, LA, USA.
Davide SimonatoDepartment of Neuroradiology, Oxford University Hospitals NHS Foundation Trust, Nuffield Departments of Clinical Neurosciences and Surgical Sciences, University of Oxford, UK.
Yan-Lin LiDepartment of Neuroradiology, Oxford University Hospitals NHS Foundation Trust, Nuffield Departments of Clinical Neurosciences and Surgical Sciences, University of Oxford, UK.
Orabi HajjehDepartment of Neurology, University of Massachusetts Chan Medical School, Worcester, MA, USA.
Muhammed Amir EssibayiDepartment of Neurological Surgery and Montefiore-Einstein Cerebrovascular Research Lab, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.
Nils HenningerDepartment of Neurology, University of Massachusetts Chan Medical School, Worcester, MA, USA.
Sri Hari SundararajanDepartment of Endovascular Neurosurgery and Neuroradiology NJMS, Newark, NJ, USA.
Anna Luisa KühnDivision of Neurointerventional Radiology, Department of Radiology, University of Massachusetts Medical Center, Worcester, MA, USA.
Jane KhalifeCooper Neurological Institute, Cooper University Hospital, Cooper Medical School of Rowen University, Camden, NJ, USA.
Sherief GhozyNuffield Department of Primary Care Health Sciences and Department for Continuing Education (EBHC Program), University of Oxford, Oxford, UK.
Luca ScarciaDepartment of Neuroradiology, Henri Mondor Hospital, Creteil, France.
Leonard Ll YeoDepartment of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Benjamin Yq TanDepartment of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Division of Neurology, Department of Medicine, National University Hospital, Singapore.
Robert W RegenhardtNeuroendovascular Program, Massachusetts General Hospital & Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Jeremy J HeitDepartment of Interventional Neuroradiology, Stanford Medical Center, Palo Alto, CA, USA.
Aymeric RouchaudUniversity Hospital of Limoges, Neuroradiology Department, Dupuytren, Université de Limoges, XLIM CNRS, UMR 7252, France.
Jens FiehlerDepartment of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Sunil ShethDepartment of Neurology, UTHealth McGovern Medical School, Houston, TX, USA.
Ajit S PuriDivision of Neurointerventional Radiology, Department of Radiology, University of Massachusetts Medical Center, Worcester, MA, USA.
Christian DyzmannNeuroradiology Department, Sana Kliniken, Lübeck GmbH, Lübeck, Germany.
Marco ColasurdoDepartment of Interventional Radiology, Oregon Health and Science University, Portland, OR 97239, USA.
Leonardo RenieriInterventistica Neurovascolare, Ospedale Careggi di Firenze, Florence, Italy.
João Pedro FilipeDepartment of Diagnostic and Interventional Neuroradiology, Centro Hospitalar Universitário Do Porto, Porto, Portugal.
Pablo HarkerDepartment of Neurology, University of Cincinnati Medical Center, Cincinnati, OH, USA.
Răzvan Alexandru RaduDepartment of Neuroradiology, Gui de Chauliac Hospital, Montpellier University Medical Center, France.
Mohamad AbdalkaderDepartments of Radiology & Neurology, Boston Medical Center, Boston, MA, USA.
Piers KleinDepartments of Radiology & Neurology, Boston Medical Center, Boston, MA, USA.
Takahiro OtaDepartment of Neurosurgery, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan.
Ashkan MowlaDivision of Stroke and Endovascular Neurosurgery, Department of Neurological Surgery, Keck School of Medicine, University of Southern California (USC), 1200 North State St, Suite 3300, Los Angeles, CA, USA.
Kareem El NaamaniDepartment of Neurosurgery, Thomas Jefferson University, Philadelphia, PA, USA.
Pascal JabbourDepartment of Neurosurgery, Thomas Jefferson University, Philadelphia, PA, USA.
Arundhati BiswasDepartment of Neurosurgery, Westchester Medical Center at New York Medical College, Valhalla, NY, USA.
Frédéric ClarençonDepartment of Neuroradiology, Pitié-Salpêtrière Hospital, Paris, France; GRC BioFast, Sorbonne University, Paris VI, USA.
James E SieglerCooper Neurological Institute, Cooper University Hospital, Cooper Medical School of Rowen University, Camden, NJ, USA.
Thanh N NguyenDepartments of Radiology & Neurology, Boston Medical Center, Boston, MA, USA.
Ricardo VarelaDepartment of Neurology, Centro Hospitalar Universitário Do Porto, Porto, Portugal.
Amanda BakerDepartment of Neurological Surgery and Montefiore-Einstein Cerebrovascular Research Lab, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.
David AltschulDepartment of Neurological Surgery and Montefiore-Einstein Cerebrovascular Research Lab, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.
Nestor R GonzalezDepartment of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, USA.
Markus A MöhlenbruchSektion Vaskuläre und Interventionelle Neuroradiologie, Universitätsklinikum Heidelberg, Heidelberg, Germany.
Vincent CostalatDepartment of Neuroradiology, Gui de Chauliac Hospital, Montpellier University Medical Center, France.
Benjamin GoryDepartment of Interventional Neuroradiology, Nancy University Hospital, Nancy, France; INSERM U1254, IADI, Université de Lorraine, 54511 Vandoeuvre-les-Nancy, France.
Christian Paul StrackeDepartment of Radiology, Interventional Neuroradiology Section, University Medical Center Münster, Germany.
Constantin HeckerDepartments of Neurology & Neurosurgery, Christian Doppler Clinic, Paracelsus Medical University Salzburg, Austria.
Gaultier MarnatInterventional Neuroradiology Department, Bordeaux University Hospital, Bordeaux, France.
Hamza ShaikhCooper Neurological Institute, Cooper University Hospital, Cooper Medical School of Rowen University, Camden, NJ, USA.
Christoph J GriessenauerDepartments of Neurology & Neurosurgery, Christian Doppler Clinic, Paracelsus Medical University Salzburg, Austria.
David S LiebeskindUCLA Stroke Center and Department of Neurology Department, UCLA, Los Angeles, CA, USA.
Alessandro PedicelliUOSA Neuroradiologia Interventistica, Fondazione Policlinico Universitario A. Gemelli IRCCS Roma, Italy.
Andrea M AlexandreUOSA Neuroradiologia Interventistica, Fondazione Policlinico Universitario A. Gemelli IRCCS Roma, Italy.
Tobias D FaizyDepartment of Radiology, Neuroendovascular Program, University Medical Center Münster, Germany.
Illario TancrediDepartment of Neurology, Hôpital Civil Marie Curie, Charleroi, Belgium.
Erwah KalsoumDepartment of Neuroradiology, Henri Mondor Hospital, Creteil, France.
Boris LubiczDepartment of Diagnostic and Interventional Neuroradiology, Erasme University Hospital, Brussels, Belgium.
Aman B PatelNeuroendovascular Program, Massachusetts General Hospital & Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Maurizio FuschiDepartment of Neuroradiology, Oxford University Hospitals NHS Foundation Trust, Nuffield Departments of Clinical Neurosciences and Surgical Sciences, University of Oxford, UK.
Max WintermarkDepartment of Neuroradiology, MD Anderson Medical Center, Houston, TX 77030, USA.
Adrien GuenegoDepartment of Diagnostic and Interventional Neuroradiology, Erasme University Hospital, Brussels, Belgium.
Adam A DmytriwDepartment of Neuroradiology, Oxford University Hospitals NHS Foundation Trust, Nuffield Departments of Clinical Neurosciences and Surgical Sciences, University of Oxford, UK; Neuroendovascular Program, Massachusetts General Hospital & Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. Electronic address: admytriw@mgh.harvard.edu.
MAD MT Investigators

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Medium vessel occlusion (MeVO) contributes significantly to acute ischemic stroke (AIS). The hypoperfusion intensity ratio (HIR), reflecting collateral circulation via the ratio of Tmax >10s to Tmax >6s volumes, predicts infarct progression in large-vessel occlusions but is unstudied in MeVOs. In this multicenter, multinational retrospective study, we evaluated consecutive patients with MeVO who underwent mechanical thrombectomy with or without intravenous thrombolysis. Inclusion required available follow-up imaging and pretreatment CT perfusion. Follow-up infarct volume (FIV) was measured on CT or MRI 12-36 ​h post-procedure. Univariable and multivariable linear regression models were used to identify predictors of FIV, with HIR as the primary variable of interest. Among 147 patients (median age 75 years, 57 ​% female), univariable analysis showed HIR was significantly associated with larger FIV (β ​= ​80 ​mL; p ​< ​0.001). After adjusting for confounders, HIR remained independently associated with FIV (β ​= ​40 ​mL; p ​< ​0.001). Tmax >10 ​s showed the strongest correlation with FIV (r ​= ​0.56; p ​< ​0.001). These findings suggest that higher HIR correlates with larger infarct volumes, underscoring the prognostic role of collateral failure in MeVO and highlighting HIR as a potential imaging marker to guide treatment and outcome prediction.

Indexed as

Cerebrovascular CirculationIschemic StrokeAgedAged, 80 and overCollateral CirculationFemaleFollow-Up StudiesHumansMagnetic Resonance ImagingMaleMiddle AgedRetrospective StudiesAcute Ischemic StrokeCollateral CirculationCT Perfusion (CTP)Distal OcclusionsFollow-Up Infarct Volume (FIV)Hypoperfusion Intensity Ratio (HIR)Mechanical ThrombectomyMedium Vessel Occlusion (MeVO)Stroke OuTmax Thresholds

Identifiers

PMID40829981
PMCPMC12664488

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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.