TY - JOUR
T1 - Tmax Mismatch Ratio to Identify Intracranial Atherosclerotic Stenosis-Related Large-Vessel Occlusion Before Endovascular Therapy
AU - Yoshimoto, Takeshi
AU - Inoue, Manabu
AU - Tanaka, Kanta
AU - Koge, Junpei
AU - Shiozawa, Masayuki
AU - Kamogawa, Naruhiko
AU - Ishiyama, Hiroyuki
AU - Abe, Soichiro
AU - Imamura, Hirotoshi
AU - Kataoka, Hiroharu
AU - Koga, Masatoshi
AU - Ihara, Masafumi
AU - Toyoda, Kazunori
N1 - Publisher Copyright:
© 2023 The Authors.
PY - 2023
Y1 - 2023
N2 - BACKGROUND: We aimed to clarify which time-to-maximum of the tissue residue function (Tmax) mismatch ratio is useful in pre-dicting anterior intracranial atherosclerotic stenosis (ICAS)–related large-vessel occlusion (LVO) before endovascular therapy. METHODS AND RESULTS: Patients with ischemic stroke who underwent perfusion-weighted imaging before endovascular therapy for anterior intracranial LVO were divided into those with ICAS-related LVO and those with embolic LVO. Tmax ratios of >10 s/>8 s, >10 s/>6 s, >10 s/>4 s, >8 s/>6 s, >8 s/>4 s, and >6 s/>4 s were considered Tmax mismatch ratios. Binominal logistic regression was used to identify ICAS-related LVO, and the adjusted odds ratio (aOR) and 95% CI for each Tmax mismatch ratio increase of 0.1 were calculated. A similar analysis was performed for ICAS-related LVO with and without embolic sources, using embolic LVO as the reference. Of 213 patients (90 women [42.0%]; median age, 79 years), 39 (18.3%) had ICAS-related LVO. The aOR (95% CI) per 0.1 increase in Tmax mismatch ratio in ICAS-related LVO with embolic LVO as reference was lowest with Tmax mismatch ratio >10 s/>6 s (0.56 [0.43–0.73]). Multinomial logistic regression analysis also showed the lowest aOR (95% CI) per 0.1 increase in Tmax mismatch ratio with Tmax >10 s/>6 s (ICAS-related LVO without embolic source: 0.60 [0.42–0.85]; ICAS-related LVO with embolic source: 0.55 [0.38–0.79]). CONCLUSIONS: A Tmax mismatch ratio of >10 s/>6 s was the optimal predictor of ICAS-related LVO compared with other Tmax profiles, with or without an embolic source before endovascular therapy. REGISTRATION: clinicaltrials.gov. Identifier NCT02251665.
AB - BACKGROUND: We aimed to clarify which time-to-maximum of the tissue residue function (Tmax) mismatch ratio is useful in pre-dicting anterior intracranial atherosclerotic stenosis (ICAS)–related large-vessel occlusion (LVO) before endovascular therapy. METHODS AND RESULTS: Patients with ischemic stroke who underwent perfusion-weighted imaging before endovascular therapy for anterior intracranial LVO were divided into those with ICAS-related LVO and those with embolic LVO. Tmax ratios of >10 s/>8 s, >10 s/>6 s, >10 s/>4 s, >8 s/>6 s, >8 s/>4 s, and >6 s/>4 s were considered Tmax mismatch ratios. Binominal logistic regression was used to identify ICAS-related LVO, and the adjusted odds ratio (aOR) and 95% CI for each Tmax mismatch ratio increase of 0.1 were calculated. A similar analysis was performed for ICAS-related LVO with and without embolic sources, using embolic LVO as the reference. Of 213 patients (90 women [42.0%]; median age, 79 years), 39 (18.3%) had ICAS-related LVO. The aOR (95% CI) per 0.1 increase in Tmax mismatch ratio in ICAS-related LVO with embolic LVO as reference was lowest with Tmax mismatch ratio >10 s/>6 s (0.56 [0.43–0.73]). Multinomial logistic regression analysis also showed the lowest aOR (95% CI) per 0.1 increase in Tmax mismatch ratio with Tmax >10 s/>6 s (ICAS-related LVO without embolic source: 0.60 [0.42–0.85]; ICAS-related LVO with embolic source: 0.55 [0.38–0.79]). CONCLUSIONS: A Tmax mismatch ratio of >10 s/>6 s was the optimal predictor of ICAS-related LVO compared with other Tmax profiles, with or without an embolic source before endovascular therapy. REGISTRATION: clinicaltrials.gov. Identifier NCT02251665.
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U2 - 10.1161/JAHA.123.029899
DO - 10.1161/JAHA.123.029899
M3 - Article
C2 - 37421278
AN - SCOPUS:85165219833
SN - 2047-9980
VL - 12
JO - Journal of the American Heart Association
JF - Journal of the American Heart Association
IS - 14
M1 - e029899
ER -