Clinical Neuroradiology最新文献

{"title":"Risk Factors for Morphological Progression of Vertebrobasilar Dolichoectasia During the Aging Process: a Magnetic Resonance Angiography Cohort Study.","authors":"Yuhan Xu, Zehui Jin, Chunming Xie, Yijing Guo, Jian Xie","doi":"10.1007/s00062-026-01731-8","DOIUrl":"https://doi.org/10.1007/s00062-026-01731-8","url":null,"abstract":"<p><strong>Background: </strong>Vertebrobasilar dolichoectasia (VBD) has emerged as a significant vascular degenerative disorder in older population, but lacks effective prevention and treatment. We aimed to determine clinical features linked to VBD progression and identify risk factors for ischemic stroke in patients with VBD.</p><p><strong>Methods: </strong>This retrospective cohort study included 191 VBD patients with baseline and follow-up MRA. Vertebral/basilar artery (VA/BA) geometric parameters were quantified using 3D-Slicer, and VBD progression was defined by annual growth rates of BA parameters. Logistic regression identified factors associated with VBD progression or new-onset stroke, and independent predictors were incorporated into nomograms.</p><p><strong>Results: </strong>Over a median 7.7-year follow-up, 88 patients showed VBD progression. Logistic regression identified baseline age (OR = 0.91), diabetes (OR = 3.19), white matter hyperintensities (WMH) severity (OR = 1.70), and unilateral vertebral artery dominance (UVD) (OR = 5.53) as independent risk factors. Nontraditional factors associated with increased risk of subsequent posterior-circulation ischemic stroke in VBD patients were complex shapes of VBA (OR = 1.74) and VBD progression (OR = 2.47). Nomograms incorporating these factors demonstrated excellent discriminative performance for both outcomes.</p><p><strong>Conclusion: </strong>This study suggests that young age, diabetes, severe WMH, and UVD are independent risk factors for rapid VBD progression, thereby further increasing the likelihood of ischemic stroke in posterior circulation territory. These findings highlight that managing modifiable factors in VBD progression may help to reduce the occurrence of ischemic stroke.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149104880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to: Intensive Blood Pressure Control After Endovascular Thrombectomy for Acute Ischemic Stroke: a Systematic Review and Meta-Analysis.","authors":"Mohamed Abuelazm, Yehya Khlidj, Ahmed A Ibrahim, Abdelrahman Mahmoud, Ahmed Mazen Amin, Ibrahim Gowaily, Ubaid Khan, Basel Abdelazeem, James Robert Brašić","doi":"10.1007/s00062-026-01727-4","DOIUrl":"https://doi.org/10.1007/s00062-026-01727-4","url":null,"abstract":"","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149104555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Catheter-Induced Flow Compromise on the Presence of Multiple Ischemic Lesions in Endovascular Treatment of Posterior Circulation Aneurysms: A Two-Center Retrospective Study.","authors":"Nagatsuki Tomura, Kento Asakura, Tomoyuki Tsumoto, Fukutaro Ohgaki, Jo Sasame, Shigeo Matsunaga, Takashi Shuto","doi":"10.1007/s00062-026-01730-9","DOIUrl":"https://doi.org/10.1007/s00062-026-01730-9","url":null,"abstract":"<p><strong>Purpose: </strong>Catheter-induced flow compromise (CFC) occurs during endovascular treatment of posterior circulation aneurysms; however, its embolic risk-particularly that of incomplete flow stasis as distinct from complete wedge-remains poorly characterized. We aimed to define CFC angiographically and evaluate its association, including subtype-specific effects, with multiple new ischemic lesions (MNIL) on postoperative diffusion-weighted imaging (DWI).</p><p><strong>Methods: </strong>We retrospectively reviewed 108 patients treated for posterior circulation aneurysms at two institutions. CFC was defined angiographically as either flow stasis or wedge and was assessed independently by two blinded readers. Predictors of the primary outcome-multiple (≥ 3) new ischemic lesions on postoperative DWI-were identified by multivariable logistic regression adjusted for age, rupture status, and use of a double-catheter system.</p><p><strong>Results: </strong>CFC occurred in 56.5% of patients and MNIL in 33.3%. Aneurysm rupture and CFC were independent predictors of MNIL (CFC: adjusted OR, 3.30; 95% CI, 1.18-9.23; p = 0.023), and both subtypes remained significant. The association was of similar magnitude when the eight patients managed with intraprocedural contralateral angiography were excluded (adjusted OR, 3.36; 95% CI, 1.20-9.44). Tortuosity at the vertebral artery origin was the principal predictor of CFC, and inter-rater agreement for CFC was almost perfect.</p><p><strong>Conclusion: </strong>CFC was independently associated with MNIL in posterior circulation aneurysm embolization and occurred more frequently in patients with tortuosity at the vertebral artery origin, supporting preoperative assessment of vessel anatomy. Incomplete flow stasis carried a substantial embolic risk, warranting the same vigilance as wedge. Determining whether intraprocedural risk-avoidance strategies reduce the ischemic burden requires prospective evaluation.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149104849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiation Exposure in Elective Endovascular Carotid Artery Stenting.","authors":"Sabine Sari, Jonas Wilde, Alexander Brose, Tobias Struffert","doi":"10.1007/s00062-026-01728-3","DOIUrl":"https://doi.org/10.1007/s00062-026-01728-3","url":null,"abstract":"<p><strong>Objectives: </strong>To systematically assess radiation exposure during elective carotid artery stenting (CAS) for symptomatic extracranial carotid stenosis at a high-volume centre and to generate data that support optimization of both radiation dose and procedural workflow, thereby providing a basis for future multicentre studies aimed at establishing diagnostic reference levels.</p><p><strong>Methods: </strong>Demographic (age, gender, BMI), procedural (balloon dilatations, procedure time), dosimetric (dose-area product [DAP], fluoroscopy time, number of acquisition series), anatomical, and interventionalist-related factors were retrospectively analysed in 109 patients undergoing CAS on a biplane flat-panel system using a standardized workflow and dedicated low-dose protocol. Nonparametric statistics were applied; p < 0.05 was considered significant.</p><p><strong>Results: </strong>Mean total DAP was 3342.12 ± 1679.36 cGy·cm² (median 2884.61 cGy·cm²), with fluoroscopy contributing 47% (mean 1666.37 ± 1122.03 cGy·cm²). Gender, anatomical side, and stenosis characteristics had no significant impact, whereas age and BMI were positively associated with total DAP (p = 0.047 and 0.014). Total DAP correlated with procedure time (rₛ = 0.491, p < 0.001), fluoroscopy time (rₛ = 0.666, p < 0.001), and number of acquisition series (rₛ = 0.364, p < 0.001). Plane A was used more frequently than plane B (p < 0.001). Procedures performed by the senior interventionalist (> 20 years experience) showed significantly lower fluoroscopy DAP (p = 0.004), shorter procedure and fluoroscopy times, and fewer acquisition series.</p><p><strong>Conclusions: </strong>Elective CAS can be performed with low radiation exposure using standardized workflows and low-dose imaging. Radiation exposure is influenced by patient characteristics, procedural factors, and interventionalist experience. These data may provide a foundation for future multicentre studies aimed at establishing DRLs and optimizing dose-reduction strategies in neuroendovascular practice.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149069411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deep Learning-Based Image Reconstruction in Ultra-High-Resolution CT Venography for Improved Visualization of Cerebral Venous Drainage.","authors":"Sebastian Steinmetz, Anna W Grebe, Mariya Kondova, Mario Alberto Abello Mercado, Antoine P Sanner, Andrea Kronfeld, Lukas Müller, Tobias Jorg, Marianne Hahn, Timo Uphaus, Marc A Brockmann, Ahmed E Othman","doi":"10.1007/s00062-026-01726-5","DOIUrl":"10.1007/s00062-026-01726-5","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the diagnostic confidence and image quality of deep-learning-enhanced ultra-high-resolution CT venography (CTV) in venous neurovascular imaging, compared with hybrid iterative reconstruction of ultra-high-resolution CT datasets and normal-resolution CTV.</p><p><strong>Methods: </strong>This retrospective, single-center study included 31 consecutive patients with suspected cerebral venous and dural sinus thrombosis who underwent CTV. CTV datasets were reconstructed using hybrid iterative reconstruction with (i) Normal-Resolution CTV (NR-CTV), (ii) an Ultra-High-Resolution CTV (UHR-CTV), and (iii) a deep learning algorithm specifically trained for neurovascular imaging, applied to the UHR-CTV datasets (DL-UHR-CTV). Quantitative analyses included signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and frequency power spectra (FPS). Qualitative evaluation of image quality, contrast, noise, artifacts, diagnostic confidence, and assessability of dural sinuses and intracranial veins was performed by three radiologists using a 4-point Likert scale. A descriptive analysis assessed concordant detection of venous pathologies across reconstructions.</p><p><strong>Results: </strong>SNR and CNR in DL-UHR-CTV were significantly higher than in UHR-CTV (SNR: p = 0.02; CNR: p = 0.01). NR-CTV and DL-UHR-CTV were similar. Compared to NR-CTV and UHR-CTV, DL-UHR-CTV showed a significantly lower FPS amplitude across wide frequency ranges. In qualitative analysis, DL-UHR-CTV outperformed UHR-CTV in all parameters (p < 0.001) except vessel contrast (p = 0.09) and was better than NR-CTV in all categories (p < 0.001). All 20 venous pathologies (12 patients) were detected on all three reconstructions without false-positive findings.</p><p><strong>Conclusion: </strong>Deep-learning-based reconstruction significantly enhances image quality and venous visualization in ultra-high-resolution CT venography compared with conventional iterative reconstruction, enabling detailed depiction of small venous structures.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149029955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Implementation and Performance of Real-Time AI System for Device Tracking in Neurointervention: First U.S. Evaluation of Neuro-Vascular Assist.","authors":"João Victor Sanders, Joshua Jimenez, Marion Oliver, Kenichi Kono, Krishna C Joshi, Demetrius Lopes","doi":"10.1007/s00062-026-01723-8","DOIUrl":"https://doi.org/10.1007/s00062-026-01723-8","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the first U.S.-based implementation, notification accuracy, and temporal operator response of Neuro-Vascular Assist.</p><p><strong>Methods: </strong>In a single-center study, 21 consecutive neurointerventional cases were performed using the AI system integrated with a biplane angiographic system. Procedures were classified as \"Standard\", \"Coil\", \"Filter\", or \"Venous\". Neuro-Vascular Assist tracked devices including guidewires, stents, coils, and filters in real-time. Visual and audio notifications were made based on device entry and exit in a determined region of interest. We classified these notifications as true positives (TP), false positives (FP), and false negatives (FN), and further assessed for temporal operator response (TOR).</p><p><strong>Results: </strong>The AI system was successfully integrated into the workflow without procedural delays or system failures affecting notification delivery. A total of 232 TPs, 13 FPs, and 17 FNs were recorded, resulting in an overall precision of 94.7% and recall of 93.2%. Among the 59 TP notifications evaluated for TOR, 25 (42.4%) were followed by an observable operator response within 10 s. These 25 positive TOR events represented 10.2% of all 245 notifications.</p><p><strong>Conclusion: </strong>Neuro-Vascular Assist was successfully implemented and demonstrated preliminary accuracy and feasibility in a U.S.-based neurointerventional setting. Larger prospective studies are warranted to determine whether real-time AI-assisted device tracking influences procedural decision-making, workflow, safety, or clinical outcomes.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149015952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In-Vitro Comparison of Cyclic Aspiration and Superbore Aspiration Catheters to Conventional 6Fr Aspiration for LVO Stroke.","authors":"Ameer E Hassan, Miquel Murillo Artigues, Akorede Rei Adedeji, Liam Mullins, John Thornton, Sean Fitzgerald","doi":"10.1007/s00062-026-01722-9","DOIUrl":"https://doi.org/10.1007/s00062-026-01722-9","url":null,"abstract":"<p><strong>Purpose: </strong>The aim was to compare conventional aspiration (CA) using 6Fr catheters with two emerging techniques: Superbore Aspiration Catheters (SAC), which have a 0.088″ lumen, and Cyclic Aspiration (CycA), which combines a 6Fr aspiration catheter with a cyclic pressure waveform, both aiming to improve revascularization and minimize distal embolization.</p><p><strong>Methods: </strong>Ovine blood clots (soft, mixed, stiff) were lodged in the ICA and M1 of an in-vitro thrombectomy model. A proprietary cyclic aspiration waveform was optimized. React 71 was used for the CA and CycA groups; Millipede88 was used for SAC. Key endpoints for assessing differences between techniques were First Pass Effect (FPE), Complete Clot Ingestion (CCI), Final Complete Revascularization (mTICI 2c/3 within three passes), and distal emboli rates.</p><p><strong>Results: </strong>SAC had the highest rates of FPE (ICA; 32%, MCA; 88%) and Final Complete Revascularization (ICA; 91%, MCA; 91%). Compared to CA, CycA was associated with numerically higher rates of CCI (26% vs 9%) and FPE (29% vs 21%) in ICA occlusions. CycA had similar rates of CCI (62% vs 59%) and a lower rate of FPE (62% vs 71%) in MCA occlusions, compared to CA. CycA and CA had similar rates of Final Complete Revascularization (ICA; 79% vs 79%, MCA; 79% vs 82%). SAC had the least distal emboli in both MCA and ICA occlusions. CycA had the most distal emboli overall, particularly for ICA occlusions.</p><p><strong>Conclusion: </strong>SAC demonstrated superior revascularization performance in-vitro compared to CycA and CA, improving both FPE and Final Complete Revascularization. CycA was associated with higher observed rates of CCI and FPE in the ICA, but generated more distal emboli.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148982107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Safety and Efficacy of Dual Antiplatelet Therapy Regimens in Flow Diversion for Intracranial Aneurysms: a Systematic Review and Network Meta-Analysis.","authors":"Marco Frusteri, Anuraag Punukollu, Miguel Gaviria Zapata, Jhoan Sebastián Robledo Arias, Esteban Quiceno","doi":"10.1007/s00062-026-01705-w","DOIUrl":"https://doi.org/10.1007/s00062-026-01705-w","url":null,"abstract":"<p><strong>Purpose: </strong>Dual antiplatelet therapy is required after flow-diverter treatment of intracranial aneurysms, but the comparative safety and efficacy of clopidogrel-, ticagrelor-, and prasugrel-based regimens remain uncertain. Therefore, the purpose of this study was to compare ischemic, hemorrhagic, functional, and mortality outcomes among different P2Y12 inhibitor-based dual antiplatelet therapy regimens after flow diversion for intracranial aneurysms.</p><p><strong>Methods: </strong>A systematic review and frequentist random-effects network meta-analysis were performed according to PRISMA guidelines. PubMed, Embase, and CENTRAL were searched from inception through February 2026. Eligible studies included randomized and nonrandomized comparative studies evaluating clopidogrel-, ticagrelor-, or prasugrel-based dual antiplatelet therapy after flow-diverter treatment. Outcomes were expressed as odds ratios with 95% confidence intervals relative to clopidogrel. Heterogeneity, consistency, treatment ranking by P‑scores, risk of bias, publication bias, and certainty of evidence were assessed.</p><p><strong>Results: </strong>Eleven studies including 2267 patients, at least 2285 procedures, and 2502 aneurysms were included. Compared with clopidogrel-based therapy, ticagrelor- and prasugrel-based regimens showed no statistically significant differences in early ischemic or hemorrhagic complications, ischemic or hemorrhagic complications at longest follow-up, or mortality. Ticagrelor was associated with lower odds of a good functional outcome compared with clopidogrel. Prasugrel ranked highest for ischemic outcomes at longest follow-up, hemorrhagic outcomes at longest follow-up, and good functional outcome. Certainty of evidence was low or very low.</p><p><strong>Conclusions: </strong>Current FD-specific evidence is insufficient to establish superiority, inferiority, or equivalence among clopidogrel-, ticagrelor-, and prasugrel-based DAPT regimens across ischemic, hemorrhagic, functional, and survival outcomes. Because treatment allocation was non-random and alternative regimens were preferentially used in patients with suspected clopidogrel hyporesponsiveness, these findings should not be read as supporting a clopidogrel-first hierarchy; regimen selection is likely to remain guided by local pharmacogenetic testing, and cost considerations pending higher-quality comparative data.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148911037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sustainability in Neurointervention-Results from an Exploratory International Cross-sectional Online Survey Among Peers.","authors":"Johannes Alex Rolf Pfaff, Johanna Ospel, Katharina Gabriela Pfaff, Katharina Haider, Kazutaka Uchida, Gregor Kasprian, Petra Cimflova, Sami Al Kasab, Razvan Alexandru Radu, Hesham Masoud, Thanh N Nguyen, Charlotte Weyland","doi":"10.1007/s00062-026-01717-6","DOIUrl":"https://doi.org/10.1007/s00062-026-01717-6","url":null,"abstract":"<p><strong>Purpose: </strong>Neurointerventional procedures, which are resource-intensive and generate significant waste, remain a major environmental challenge. This international survey aimed to explore the awareness, practices, and barriers surrounding sustainability in neurointervention.</p><p><strong>Methods: </strong>A cross-sectional online survey was conducted among neurointerventional specialists using a convenience sampling approach. The questionnaire focused on sustainability awareness, surgical gown preferences, workplace sustainability initiatives, perceived barriers, and support for sustainability measures.</p><p><strong>Results: </strong>One-hundred-thirty-eight respondents completed the survey between October 15th, 2025 and December 15th, 2025 (107 [77.5%] male, with a background in neuroradiology [88/138, 63.8%], neurology [32/138, 23.2%], and neurosurgery [16/138, 11.6%]). Results revealed a gap between personal and professional sustainability actions, with respondents engaging more in sustainable practices in private life than at work. While 78.7% prioritized sustainability privately, only 71.7% did so professionally. Key barriers to implementing sustainability included \"limited alternatives\", \"lack of awareness\", and \"inadequate financial incentives\". However, there was strong support for sustainability initiatives, especially in areas such as sustainable procurement and events organized by professional societies. Notably, despite a preference for reusable surgical gowns (75.9%), disposable gowns dominated current practice (76.7%).</p><p><strong>Conclusion: </strong>This study suggests a gap between neurointerventional specialists' personal sustainability preferences and professional practices, which may be influenced by systemic barriers. While respondents generally expressed support for sustainable initiatives, broader adoption likely requires structural changes at institutional and policy levels.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148911070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Significance of Asymptomatic Intracranial Hemorrhage Following Thrombectomy for Large-Vessel Occlusion: Insight from the ANGEL-ACT Registry.","authors":"Xin Guo, Yiyang Sun, Raynald, Muhammad Firdaus, Thanh N Nguyen, Jing Wang, Zhongrong Miao","doi":"10.1007/s00062-026-01721-w","DOIUrl":"https://doi.org/10.1007/s00062-026-01721-w","url":null,"abstract":"<p><strong>Background and purpose: </strong>The prognostic significance of asymptomatic intracranial hemorrhage (aICH) after endovascular thrombectomy (EVT) for acute ischemic stroke remains uncertain. We investigated the association between aICH and clinical outcomes using data from a large prospective registry.</p><p><strong>Methods: </strong>We analyzed patients with anterior circulation large-vessel occlusion from the ANGEL-ACT registry (November 2017 to March 2019) who underwent EVT. Patients were categorized into aICH, symptomatic ICH (sICH), and no ICH groups. The primary endpoint was 90-day modified Rankin Scale (mRS) score 0-2, and the safety outcome was death within 90 days. Multivariable logistic regression was performed to identify independent predictors of aICH.</p><p><strong>Results: </strong>Among 1252 eligible patients, 221 (17.7%) developed aICH, 117 (9.3%) had sICH, and 914 had no ICH. Compared with patients without ICH, those with aICH had a lower rate of 90-day mRS 0-2 (13.6% vs 53.6%; OR 2.62, 95% CI 1.47 to 4.65; p = 0.001). No statistically significant difference was observed between the aICH and sICH groups despite a numerically lower rate of functional independence in the sICH group (13.6% vs 34.0%; OR 0.47, 95% CI 0.18 to 1.25; p = 0.131). Compared with patients with aICH, 90-day mortality was significantly higher in the sICH group (37.9% vs. 14.0%; OR 4.93, 95% CI 1.86 to 13.04; p = 0.001), but not significantly different in the no ICH group (9.0% vs. 14.0%; OR 0.77, 95% CI 0.37 to 1.64; p = 0.502). Valvular heart disease, more thrombectomy passes, higher admission blood glucose, and vascular perforation were independent predictors of aICH.</p><p><strong>Conclusions: </strong>aICH after EVT was associated with worse functional outcomes than no ICH, while mortality was lower than in sICH.</p>","PeriodicalId":10391,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148911082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}