External Validation of Atherosclerotic Neuroimaging Biomarkers in Emergent Large‐Vessel Occlusion
نویسندگان
چکیده
Background Intracranial atherosclerosis related large vessel occlusion (ICAS‐LVO) is the major cause of failed mechanical thrombectomy. ICAS‐LVO causes reocclusion or a fixed focal stenosis, leading to suboptimal revascularization and poor functional outcomes. We aimed externally validate 4 preidentified imaging biomarkers ICAS‐LVO: absent hyperdense sign, Hounsfield units (Hu ratio ≤1.1 Delta Hu <6) truncal‐type occlusion, observed on admission noncontrast computed tomography angiography in patients presenting with emergent large‐vessel (ELVO). Methods conducted retrospective cohort observational study consecutive acute M1/terminal internal carotid artery occlusions undergoing Inability locate at corresponding ELVO was labeled sign. were defined as difference its mirror contralateral patent vessel, respectively. classified if bifurcation distal spared angiography. presence stenosis after Statistical analysis performed using C statistics, receiver operating characteristic curve analysis, multivariate logistic regression. Results Of 161 patients, 30 (18.6%) had suspected ICAS‐LVO. Absent sign sensitivity 90% specificity 87% (area under [AUC], 0.88), predicting (AUC, 0.89) <6 0.96) 100% 97% 79% 95%, Truncal‐type showed 75% 98% 0.87). When comparing AUC, significantly better than ( P =0.006); =0.02). Conclusion Combination neuroimaging identify high predictive power. Larger, prospective, multicenter studies are warranted further evaluate their effectiveness diagnosing
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ژورنال
عنوان ژورنال: Stroke: vascular and interventional neurology
سال: 2023
ISSN: ['2694-5746']
DOI: https://doi.org/10.1161/svin.123.000850