Journal of Stroke最新文献

{"title":"Tenecteplase Versus Alteplase in Medium Vessel Occlusion Ischemic Stroke: A Secondary Analysis of the Alteplase Compared to Tenecteplase Randomized Trial.","authors":"Fouzi Bala, Nishita Singh, Katrina Ignacio, Ibrahim Alhabli, Ayoola Ademola, Anas Alrohimi, Houman Khosravani, Aleksander Tkach, Luciana Catanese, Dariush Dowlatshahi, Thalia Field, Gary Hunter, Faysal Benali, MacKenzie Horn, Andrew Demchuk, Michael Hill, Tolulope Sajobi, Brian Buck, Richard Swartz, Mohammed Almekhlafi, Bijoy K Menon","doi":"10.5853/jos.2023.03713","DOIUrl":"10.5853/jos.2023.03713","url":null,"abstract":"<p><strong>Background and purpose: </strong>The safety and efficacy of tenecteplase in patients with ischemic stroke due to medium vessel occlusion (MeVO) are not well studied. We aimed to compare tenecteplase with alteplase in stroke due to MeVO.</p><p><strong>Methods: </strong>Patients with baseline M2-middle cerebral artery (MCA), M3/M4-MCA, P2/P3/P4-posterior cerebral artery (PCA), A2/A3/A4-anterior cerebral artery (ACA) occlusions from the Alteplase Compared to Tenecteplase (AcT) trial were included. Primary outcome was the proportion of 90-day modified Rankin Scale (mRS) 0-1. Secondary outcomes were 90-day mRS 0-2, ordinal mRS, mortality, quality of life measures (EuroQol 5-Dimension 5-Level, EuroQol visual analog scale), and symptomatic intracerebral hemorrhage (sICH). Initial and final successful reperfusion were reported in patients undergoing endovascular thrombectomy (EVT).</p><p><strong>Results: </strong>Among 1,558 patients with available baseline computed tomography angiography; 455 (29.2%) had MeVO of which 27.5% (125/455) were proximal M2; 16.3% (74/455) were distal M2; 35.2% (160/455) were M3/M4; 7.5% (34/455) were A2/A3/A4; and 13.6% (62/455) were P2/P3/P4 occlusions. EVT was performed in 87/455 (19.1%) patients. mRS 0-1 at 90 days was achieved in 37.9% in the tenecteplase versus 34.7% in the alteplase group (adjusted risk ratio [aRR] 1.07; 95% confidence interval [CI] 0.91-1.25). Rates of 90-day mRS 0-2, sICH, and mortality were similar in both groups. No statistical difference was noted in initial successful reperfusion rates (13.0% vs. 7.5%) among the 87 patients who underwent endovascular thrombectomy. However, final successful reperfusion was higher in the tenecteplase group (71.7% vs. 60.0%, aRR 1.29, 95% CI 1.04-1.61).</p><p><strong>Conclusion: </strong>Intravenous tenecteplase had comparable safety, functional outcomes and quality of life compared to intravenous alteplase among patients with MeVO. Among those treated with EVT, tenecteplase was associated with higher successful reperfusion rates than alteplase.</p>","PeriodicalId":17135,"journal":{"name":"Journal of Stroke","volume":"26 2","pages":"280-289"},"PeriodicalIF":8.2,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11164589/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141248378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endovascular Therapy in the Extended Time Window for Large Vessel Occlusion in Patients With Pre-Stroke Disability.","authors":"Kanta Tanaka, Hiroshi Yamagami, Muhammad M Qureshi, Kazutaka Uchida, James E Siegler, Raul G Nogueira, Shinichi Yoshimura, Nobuyuki Sakai, Nicolas Martinez-Majander, Simon Nagel, Jelle Demeestere, Volker Puetz, Diogo C Haussen, Mohamad Abdalkader, Marta Olive-Gadea, Mahmoud H Mohammaden, João Pedro Marto, Anne Dusart, Simon Winzer, Liisa Tomppo, Francois Caparros, Hilde Henon, Flavio Bellante, João Nuno Ramos, Santiago Ortega-Gutierrez, Sunil A Sheth, Stefania Nannoni, Johannes Kaesmacher, Lieselotte Vandewalle, Sergio Salazar-Marioni, Mudassir Farooqui, Pekka Virtanen, Rita Ventura, Syed Zaidi, Alicia C Castonguay, Ajit S Puri, Behzad Farzin, Hesham E Masoud, Piers Klein, Jessica Jesser, Manuel Requena, Tomas Dobrocky, Daniel P O Kaiser, Erno Peltola, Davide Strambo, Markus A Möhlenbruch, Eugene Lin, Peter A Ringleb, Osama O Zaidat, Charlotte Cordonnier, Daniel Roy, Robin Lemmens, Marc Ribo, Daniel Strbian, Urs Fischer, Patrik Michel, Jean Raymond, Thanh N Nguyen","doi":"10.5853/jos.2023.04259","DOIUrl":"10.5853/jos.2023.04259","url":null,"abstract":"<p><strong>Background and purpose: </strong>We compared the outcomes of endovascular therapy (EVT) in an extended time window in patients with large-vessel occlusion (LVO) between patients with and without pre-stroke disability.</p><p><strong>Methods: </strong>In this prespecified analysis of the multinational CT for Late Endovascular Reperfusion study (66 participating sites, 10 countries between 2014 and 2022), we analyzed data from patients with acute ischemic stroke with a pre-stroke modified Rankin Scale (mRS) score of 0-4 and LVO who underwent EVT 6-24 hours from the time last seen well. The primary outcome was the composite of functional independence (FI; mRS score 0-2) or return to the pre-stroke mRS score (return of Rankin, RoR) at 90 days. Outcomes were compared between patients with pre-stroke disability (pre-stroke mRS score 2-4) and those without (mRS score 0-1).</p><p><strong>Results: </strong>A total of 2,231 patients (median age, 72 years; median National Institutes of Health Stroke Scale score, 16) were included in the present analysis. Of these, 564 (25%) had pre-stroke disability. The primary outcome (FI or RoR) was observed in 30.7% of patients with pre-stroke disability (FI, 16.5%; RoR, 30.7%) compared to 44.1% of patients without (FI, 44.1%; RoR, 13.0%) (P<0.001). In multivariable logistic regression analysis with inverse probability of treatment weighting, pre-stroke disability was not associated with significantly lower odds of achieving FI or RoR (adjusted odds ratio 0.73, 95% confidence interval 0.43-1.25). Symptomatic intracranial hemorrhage occurred in 6.3% of both groups (P=0.995).</p><p><strong>Conclusion: </strong>A considerable proportion of patients with late-presenting LVO and pre-stroke disability regained pre-stroke mRS scores after EVT. EVT may be appropriate for patients with pre-stroke disability presenting in the extended time window.</p>","PeriodicalId":17135,"journal":{"name":"Journal of Stroke","volume":"26 2","pages":"269-279"},"PeriodicalIF":8.2,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11164586/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141248298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Infarcts Due to Large Vessel Occlusions Continue to Grow Despite Near-Complete Reperfusion After Endovascular Treatment.","authors":"Johanna M Ospel, Nathaniel Rex, Karim Oueidat, Rosalie McDonough, Leon Rinkel, Grayson Baird, Scott Collins, Gaurav Jindal, Matthew D Alvin, Jerrold Boxerman, Phil Barber, Mahesh Jayaraman, Wendy Smith, Amanda Amirault-Capuano, Michael D Hill, Mayank Goyal, Ryan McTaggart","doi":"10.5853/jos.2023.02621","DOIUrl":"10.5853/jos.2023.02621","url":null,"abstract":"<p><strong>Background and purpose: </strong>Infarcts in acute ischemic stroke (AIS) patients may continue to grow even after reperfusion, due to mechanisms such as microvascular obstruction and reperfusion injury. We investigated whether and how much infarcts grow in AIS patients after near-complete (expanded Thrombolysis in Cerebral Infarction [eTICI] 2c/3) reperfusion following endovascular treatment (EVT), and to assess the association of post-reperfusion infarct growth with clinical outcomes.</p><p><strong>Methods: </strong>Data are from a single-center retrospective observational cohort study that included AIS patients undergoing EVT with near-complete reperfusion who received diffusion-weighted magnetic resonance imaging (MRI) within 2 hours post-EVT and 24 hours after EVT. Association of infarct growth between 2 and 24 hours post-EVT and 24-hour National Institutes of Health Stroke Scale (NIHSS) as well as 90-day modified Rankin Scale score was assessed using multivariable logistic regression.</p><p><strong>Results: </strong>Ninety-four of 155 (60.6%) patients achieved eTICI 2c/3 and were included in the analysis. Eighty of these 94 (85.1%) patients showed infarct growth between 2 and 24 hours post-reperfusion. Infarct growth ≥5 mL was seen in 39/94 (41.5%) patients, and infarct growth ≥10 mL was seen in 20/94 (21.3%) patients. Median infarct growth between 2 and 24 hours post-reperfusion was 4.5 mL (interquartile range: 0.4-9.2 mL). Post-reperfusion infarct growth was associated with the 24-hour NIHSS in multivariable analysis (odds ratio: 1.16 [95% confidence interval 1.09-1.24], P<0.01).</p><p><strong>Conclusion: </strong>Infarcts continue to grow after EVT, even if near-complete reperfusion is achieved. Investigating the underlying mechanisms may inform future therapeutic approaches for mitigating the process and help improve patient outcome.</p>","PeriodicalId":17135,"journal":{"name":"Journal of Stroke","volume":"26 2","pages":"260-268"},"PeriodicalIF":8.2,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11164585/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141248307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuroprotective Approaches for Brain Injury After Cardiac Arrest: Current Trends and Prospective Avenues.","authors":"Subash Marasini, Xiaofeng Jia","doi":"10.5853/jos.2023.04329","DOIUrl":"10.5853/jos.2023.04329","url":null,"abstract":"<p><p>With the implementation of improved bystander cardiopulmonary resuscitation techniques and public-access defibrillation, survival after out-of-hospital cardiac arrest (OHCA) has increased significantly over the years. Nevertheless, OHCA survivors have residual anoxia/reperfusion brain damage and associated neurological impairment resulting in poor quality of life. Extracorporeal membrane oxygenation or targeted temperature management has proven effective in improving post-cardiac arrest (CA) neurological outcomes, yet considering the substantial healthcare costs and resources involved, there is an urgent need for alternative treatment strategies that are crucial to alleviate brain injury and promote recovery of neurological function after CA. In this review, we searched PubMed for the latest preclinical or clinical studies (2016-2023) utilizing gas-mediated, pharmacological, or stem cell-based neuroprotective approaches after CA. Preclinical studies utilizing various gases (nitric oxide, hydrogen, hydrogen sulfide, carbon monoxide, argon, and xenon), pharmacological agents targeting specific CA-related pathophysiology, and stem cells have shown promising results in rodent and porcine models of CA. Although inhaled gases and several pharmacological agents have entered clinical trials, most have failed to demonstrate therapeutic effects in CA patients. To date, stem cell therapies have not been reported in clinical trials for CA. A relatively small number of preclinical stem-cell studies with subtle therapeutic benefits and unelucidated mechanistic explanations warrant the need for further preclinical studies including the improvement of their therapeutic potential. The current state of the field is discussed and the exciting potential of stem-cell therapy to abate neurological dysfunction following CA is highlighted.</p>","PeriodicalId":17135,"journal":{"name":"Journal of Stroke","volume":"26 2","pages":"203-230"},"PeriodicalIF":8.2,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11164592/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141248363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Discrepancy Between Ischemic Changes Observed on Non-Enhanced Computed Tomography and Perfusion Imaging: Implications for Decision-Making in Treatment.","authors":"Gabriel Broocks, Jens Fiehler, Lukas Meyer","doi":"10.5853/jos.2023.03909","DOIUrl":"10.5853/jos.2023.03909","url":null,"abstract":"","PeriodicalId":17135,"journal":{"name":"Journal of Stroke","volume":"26 2","pages":"339-341"},"PeriodicalIF":8.2,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11164595/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141248294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and Associations of Dural Arteriovenous Fistulae in Cerebral Venous Thrombosis: Analysis of ACTION-CVT.","authors":"Aaron Shoskes, Liqi Shu, Thanh N Nguyen, Mohamad Abdalkader, James Giles, Jordan Amar, James E Siegler, Nils Henninger, Marwa ElNazeir, Sami Al Kasab, Piers Klein, Mirjam R Heldner, Kateryna Antonenko, Marios Psychogios, David S Liebeskind, Thalia Field, Ava Liberman, Charles Esenwa, Alexis Simpkins, Grace Li, Jennifer Frontera, Lindsey Kuohn, Aaron Rothstein, Ossama Khazaal, Yasmin Aziz, Eva Mistry, Pooja Khatri, Setareh Salehi Omran, Adeel S Zubair, Richa Sharma, Robert M Starke, Jacques J Morcos, Jose G Romano, Shadi Yaghi, Negar Asdaghi","doi":"10.5853/jos.2023.02264","DOIUrl":"10.5853/jos.2023.02264","url":null,"abstract":"","PeriodicalId":17135,"journal":{"name":"Journal of Stroke","volume":"26 2","pages":"325-329"},"PeriodicalIF":6.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11164588/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141248366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Cerebral Amyloid Angiopathy Pathology and Strictly Lobar Microbleeds in East-Asian Versus Western Populations: A Systematic Review and Meta-Analysis.","authors":"Anna M De Kort, Marcel M Verbeek, Floris H B M Schreuder, Catharina J M Klijn, Lieke Jäkel","doi":"10.5853/jos.2023.04287","DOIUrl":"10.5853/jos.2023.04287","url":null,"abstract":"<p><strong>Background and purpose: </strong>Possible differences in the prevalence of cerebral amyloid angiopathy (CAA) in East-Asian compared to Western populations have received little attention, and results so far have been ambiguous. Our aim is to compare the prevalence of CAA neuropathology and magnetic resonance imaging markers of CAA in East-Asian and Western cohorts reflecting the general population, cognitively normal elderly, patients with Alzheimer's disease (AD), and patients with (lobar) intracerebral hemorrhage (ICH).</p><p><strong>Methods: </strong>We performed a systematic literature search in PubMed and Embase for original research papers on the prevalence of CAA and imaging markers of CAA published up until February 17th 2022. Records were screened by two independent reviewers. Pooled estimates were determined using random-effects models. We compared studies from Japan, China, Taiwan, South Korea (East-Asian cohorts) to studies from Europe or North America (Western cohorts) by meta-regression models.</p><p><strong>Results: </strong>We identified 12,257 unique records, and we included 143 studies on Western study populations and 53 studies on East-Asian study populations. Prevalence of CAA neuropathology did not differ between East-Asian and Western cohorts in any of the investigated patient domains. The prevalence of strictly lobar microbleeds was lower in East-Asian cohorts of population-based individuals (5.6% vs. 11.4%, P=0.020), cognitively normal elderly (2.6% vs. 11.4%, P=0.001), and patients with ICH (10.2% vs. 24.6%, P<0.0001). However, age was in general lower in the East-Asian cohorts.</p><p><strong>Conclusion: </strong>The prevalence of CAA neuropathology in the general population, cognitively normal elderly, patients with AD, and patients with (lobar) ICH is similar in East-Asian and Western countries. In East-Asian cohorts reflecting the general population, cognitively normal elderly, and patients with ICH, strictly lobar microbleeds were less prevalent, likely due to their younger age. Consideration of potential presence of CAA is warranted in decisions regarding antithrombotic treatment and potential new anti-amyloid-β immunotherapy as treatment for AD in East-Asian and Western countries alike.</p>","PeriodicalId":17135,"journal":{"name":"Journal of Stroke","volume":"26 2","pages":"179-189"},"PeriodicalIF":8.2,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11164577/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141248369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Atrial Cardiopathy as a Potential Cause of Embolic Stroke of Undetermined Source.","authors":"Angelo Cascio Rizzo, Ghil Schwarz, Andrea Bonelli, Andrea Di Pietro, Martina Di Pietro, Francesco Aruta, Cristina Motto, Benedetta De Chiara, Antonella Moreo, Elio Clemente Agostoni","doi":"10.5853/jos.2024.00031","DOIUrl":"10.5853/jos.2024.00031","url":null,"abstract":"","PeriodicalId":17135,"journal":{"name":"Journal of Stroke","volume":"26 2","pages":"330-334"},"PeriodicalIF":8.2,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11164580/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141248388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sodium-Glucose Cotransporter 2 Inhibitor Improves Neurological Outcomes in Diabetic Patients With Acute Ischemic Stroke.","authors":"Wookjin Yang, Jeong-Min Kim, Matthew Chung, Jiyeon Ha, Dong-Wan Kang, Eung-Joon Lee, Han-Yeong Jeong, Keun-Hwa Jung, Hyunpil Sung, Jin Chul Paeng, Seung-Hoon Lee","doi":"10.5853/jos.2023.04056","DOIUrl":"10.5853/jos.2023.04056","url":null,"abstract":"","PeriodicalId":17135,"journal":{"name":"Journal of Stroke","volume":"26 2","pages":"342-346"},"PeriodicalIF":6.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11164579/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141248374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deep Learning-Based Automatic Classification of Ischemic Stroke Subtype Using Diffusion-Weighted Images.","authors":"Wi-Sun Ryu, Dawid Schellingerhout, Hoyoun Lee, Keon-Joo Lee, Chi Kyung Kim, Beom Joon Kim, Jong-Won Chung, Jae-Sung Lim, Joon-Tae Kim, Dae-Hyun Kim, Jae-Kwan Cha, Leonard Sunwoo, Dongmin Kim, Sang-Il Suh, Oh Young Bang, Hee-Joon Bae, Dong-Eog Kim","doi":"10.5853/jos.2024.00535","DOIUrl":"10.5853/jos.2024.00535","url":null,"abstract":"<p><strong>Background and purpose: </strong>Accurate classification of ischemic stroke subtype is important for effective secondary prevention of stroke. We used diffusion-weighted image (DWI) and atrial fibrillation (AF) data to train a deep learning algorithm to classify stroke subtype.</p><p><strong>Methods: </strong>Model development was done in 2,988 patients with ischemic stroke from three centers by using U-net for infarct segmentation and EfficientNetV2 for subtype classification. Experienced neurologists (n=5) determined subtypes for external test datasets, while establishing a consensus for clinical trial datasets. Automatically segmented infarcts were fed into the model (DWI-only algorithm). Subsequently, another model was trained, with AF included as a categorical variable (DWI+AF algorithm). These models were tested: (1) internally against the opinion of the labeling experts, (2) against fresh external DWI data, and (3) against clinical trial dataset.</p><p><strong>Results: </strong>In the training-and-validation datasets, the mean (±standard deviation) age was 68.0±12.5 (61.1% male). In internal testing, compared with the experts, the DWI-only and the DWI+AF algorithms respectively achieved moderate (65.3%) and near-strong (79.1%) agreement. In external testing, both algorithms again showed good agreements (59.3%-60.7% and 73.7%-74.0%, respectively). In the clinical trial dataset, compared with the expert consensus, percentage agreements and Cohen's kappa were respectively 58.1% and 0.34 for the DWI-only vs. 72.9% and 0.57 for the DWI+AF algorithms. The corresponding values between experts were comparable (76.0% and 0.61) to the DWI+AF algorithm.</p><p><strong>Conclusion: </strong>Our model trained on a large dataset of DWI (both with or without AF information) was able to classify ischemic stroke subtypes comparable to a consensus of stroke experts.</p>","PeriodicalId":17135,"journal":{"name":"Journal of Stroke","volume":"26 2","pages":"300-311"},"PeriodicalIF":8.2,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11164582/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141248331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}