Clinical Neuroradiology最新文献

{"title":"Freiburg Neuropathology Case Conference : Headache, Mental Confusion and Mild Hemiparesis in a 68-year-old Patient.","authors":"M Frosch, T Demerath, C Fung, M Prinz, H Urbach, D Erny, C A Taschner","doi":"10.1007/s00062-023-01359-y","DOIUrl":"10.1007/s00062-023-01359-y","url":null,"abstract":"","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"1159-1164"},"PeriodicalIF":2.8,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10654210/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49693390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"58. Jahrestagung der Deutschen Gesellschaft für Neuroradiologie e.V. und 30. Jahrestagung der Österreichischen Gesellschaft für Neuroradiologie e.V.","authors":"","doi":"10.1007/s00062-023-01336-5","DOIUrl":"https://doi.org/10.1007/s00062-023-01336-5","url":null,"abstract":"","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":"33 Suppl 1","pages":"1-140"},"PeriodicalIF":2.8,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41171439","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":"Comaneci plus Balloon-assisted Embolization of Ruptured Wide-necked Cerebral Aneurysms.","authors":"A Sirakov,&nbsp;P Bhogal,&nbsp;S Bogovski,&nbsp;S Matanov,&nbsp;K Minkin,&nbsp;H Hristov,&nbsp;K Ninov,&nbsp;V Karakostov,&nbsp;M Penkov,&nbsp;S Sirakov","doi":"10.1007/s00062-021-01115-0","DOIUrl":"https://doi.org/10.1007/s00062-021-01115-0","url":null,"abstract":"<p><strong>Background and purpose: </strong>Recently, avant-garde combinations of ancillary devices as an adjunct to coil embolization for acutely ruptured and wide-necked cerebral aneurysms have emerged. This study sought to investigate the feasibility, safety and durability of the simultaneous combination of temporary neck-bridging devices plus balloon-assisted coiling (BAC) to treat acutely ruptured and wide-necked cerebral aneurysms.</p><p><strong>Methods: </strong>A retrospective review was performed of patients with ruptured and wide-necked intracranial bifurcation aneurysms treated with temporary stent plus balloon-assisted coiling. Anatomical features, technical details, intraprocedural complications, clinical and angiographic results were reviewed. Preprocedural and follow-up clinical statuses were evaluated using the modified Rankin scale (mRS).</p><p><strong>Results: </strong>A total of 21 patients (mean age 54.5 years, range 37-72 years) were identified. The immediate postprocedural angiography revealed complete aneurysm occlusion in 85.7% (18/21) of the cases. A periprocedural complication developed in 9.5% of the cases. There was no mortality in this study. The permanent morbidity rate was 4.7%. Long-term follow-up angiography was performed in 18 of 21 patients (85.7%) (the mean follow-up period was 21 months). The rate of complete aneurysm occlusion at final follow-up was 89.4%.</p><p><strong>Conclusion: </strong>The results of this study confirmed that temporary stent plus balloon-assisted coiling is a durable and relatively safe endovascular technique for the treatment of ruptured wide-necked bifurcation aneurysms located in both the posterior and anterior cerebral circulation.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":"32 3","pages":"773-782"},"PeriodicalIF":2.8,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39942962","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":"Benefits from Exclusion Treatment of Unruptured Brain Arteriovenous Malformations on Epilepsy in Adults.","authors":"Romain Capocci,&nbsp;Michaela Bustuchina Vlaicu,&nbsp;Eimad Shotar,&nbsp;Bertrand Mathon,&nbsp;Mariette Delaitre,&nbsp;Kévin Premat,&nbsp;Maichael Talaat,&nbsp;Atika Talbi,&nbsp;Anne-Laure Boch,&nbsp;Stéphanie Lenck,&nbsp;Alexandre Carpentier,&nbsp;Vincent Degos,&nbsp;Nader Antoine Sourour,&nbsp;Frédéric Clarençon","doi":"10.1007/s00062-021-01119-w","DOIUrl":"https://doi.org/10.1007/s00062-021-01119-w","url":null,"abstract":"<p><strong>Purpose: </strong>In approximately 30% of the patients, brain arteriovenous malformations (bAVMs) are revealed by seizures, which may alter the patients' quality of life. Our objective was to evaluate the benefits of exclusion treatment (radiosurgery, embolization and/or surgery) on posttherapeutic epilepsy in bAVM patients without intracranial hemorrhage prior to treatment.</p><p><strong>Methods: </strong>Our retrospective observational single-center study included all consecutive adult patients with an unruptured bAVM and epilepsy, treated at our institution from 1995 to 2019 and who were followed for at least 1 year. Data on angioarchitectural characteristics of bAVMs, on epilepsy and posttreatment modified Rankin Scale (mRS) were collected. The primary endpoint was a seizure-free status (defined as Engel class IA) after exclusion treatment versus conservative management.</p><p><strong>Results: </strong>In this study one hundred and one consecutive adult patients with bAVMs, epilepsy and without bAVM rupture before any treatment were included; 21 (21%) in the conservative management group vs. 80 (79%) in the exclusion treatment group. After exclusion treatment, 55% of the patients from the group were Engel IA after treatment vs. 10% of the conservative management group (odds ratio [OR] 11.37, 95% confidence interval [CI] 2.48-107.24, p < 0.001).</p><p><strong>Conclusion: </strong>Our results suggest that exclusion treatment in unruptured bAVMs with epilepsy is associated with a higher seizure-free rate in comparison with conservative management. Data from randomized controlled studies are necessary to confirm these findings.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":"32 3","pages":"749-760"},"PeriodicalIF":2.8,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39646341","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":"Radiolucent Zone around Screws is Associated with Position Change of Screw-rod Constructs.","authors":"Satoru Tanioka,&nbsp;Masashi Fujimoto,&nbsp;Hirofumi Nishikawa,&nbsp;Katsuhiro Tanaka,&nbsp;Fujimaro Ishida,&nbsp;Atsushi Yamamoto,&nbsp;Munenari Ikezawa,&nbsp;Yusuke Kamei,&nbsp;Hidenori Suzuki,&nbsp;Masaki Mizuno","doi":"10.1007/s00062-021-01132-z","DOIUrl":"https://doi.org/10.1007/s00062-021-01132-z","url":null,"abstract":"<p><strong>Purpose: </strong>A radiologic assessment method to measure position change of screw-rod constructs over time by superposing the 3‑dimensional images assists in quantitative evaluation of screw loosening. We investigated the association between position change and radiolucent zone that was commonly used for diagnosing screw loosening.</p><p><strong>Methods: </strong>In this study 101 patients who underwent lumbar fusion were reviewed. Patient characteristics included age, sex, indications for surgery, number of fused levels, surgical procedures, and timing of follow-up computed tomography (CT, 1-5 months, 6-11 months, and ≥ 12 months). The Hounsfield unit values of L1 vertebra on preoperative CT were measured, and the radiolucent zone on each follow-up CT was evaluated. Using baseline CT on the day after surgery and follow-up CT, 3‑dimensional images of screw-rod constructs were generated and superposed. Position change was assessed by the median of the distances between the 3‑dimensional images at baseline and follow-up using the automated measurement method. Patient characteristics, the Hounsfield unit values of L1, and the amount of position change were categorized into the radiolucent zone presence and absence groups and compared.</p><p><strong>Results: </strong>The medians of position change were 0.281 mm and 0.136 mm in the radiolucent zone presence and absence groups, respectively (P < 0.001 by Mann-Whitney U-test). The area under the curve for position change in identifying radiolucent zone was 0.846; the cut-off value was 1.76 mm. In multivariable analysis, position change was independently associated with radiolucent zone (adjusted odds ratio per 0.1 mm, 2.80, 95% confidence interval 1.70-4.61).</p><p><strong>Conclusion: </strong>Radiolucent zone was associated with position change of screw-rod constructs.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":"32 3","pages":"717-724"},"PeriodicalIF":2.8,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39803045","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":"Comparison of Four International Guidelines on the Utility of Cranial Imaging Before Lumbar Puncture in Adults with Bacterial Meningitis.","authors":"Nicola Park,&nbsp;Masayuki Nigo,&nbsp;Rodrigo Hasbun","doi":"10.1007/s00062-022-01143-4","DOIUrl":"https://doi.org/10.1007/s00062-022-01143-4","url":null,"abstract":"<p><strong>Background: </strong>International guidelines exist for obtaining a head computed tomography (CT) scan before a lumbar puncture (LP) in adults with suspected meningitis but there are no studies comparing them in their ability to identify intracranial abnormalities.</p><p><strong>Methods: </strong>A retrospective study of 202 cases of adults with community-acquired bacterial meningitis at 16 hospitals in Houston from December 2004 until May 2019 to compare the 4 guidelines' ability in identifying minor and major intracranial findings, cases in which CT findings changed management, and patients who suffered cerebral herniation.</p><p><strong>Results: </strong>Minor and major intracranial findings were seen in 69 (34.1%) and in 24 (11.8%) of the patients, respectively. A total of nine (37.5%) of the major intracranial findings prompted a neurosurgical intervention. A total of four (1.9%) patients had cerebral herniation. The Infectious Diseases of America (IDSA), the United Kingdom (UK), the European Society of Clinical Microbiology and Infectious Diseases (ESCMID), and the Swedish guidelines for cranial imaging were met in 92.1%, 54%, 41.6%, and in 23.3% of the patients, respectively. The IDSA, UK, European, and the Swedish guidelines missed 0%, 20.8%, 41.7%, and 70.8% of the major intracranial findings and 0, 1, 3 and 4 of the 9 patients that prompted a neurosurgical intervention, respectively. All four patients with cerebral herniation met the criteria for all four guidelines.</p><p><strong>Conclusion: </strong>Out of the four international guidelines, only the IDSA recommendations for cranial imaging did not miss any major intracranial abnormality or any finding that prompted a neurosurgical intervention but all guidelines identified herniation.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":"32 3","pages":"857-862"},"PeriodicalIF":2.8,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39936325","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":"Endovascular Treatment of Cavernous Sinus Dural Arteriovenous Fistulas. Institutional Series, Systematic Review and Meta-Analysis.","authors":"Andrea M Alexandre,&nbsp;Carmelo Lucio Sturiale,&nbsp;Andrea Bartolo,&nbsp;Andrea Romi,&nbsp;Alba Scerrati,&nbsp;Maria Elena Flacco,&nbsp;Francesco D'Argento,&nbsp;Luca Scarcia,&nbsp;Giuseppe Garignano,&nbsp;Iacopo Valente,&nbsp;Emilio Lozupone,&nbsp;Alessandro Pedicelli","doi":"10.1007/s00062-021-01107-0","DOIUrl":"https://doi.org/10.1007/s00062-021-01107-0","url":null,"abstract":"<p><strong>Purpose: </strong>Endovascular treatment represents the first-line therapy for cavernous sinus dural arteriovenous fistulas (CS-dAVF); however, different approaches and embolic agents as well as occlusion rates, complications and clinical outcomes are reported among the published series. In this study we performed a comprehensive meta-analysis to investigate clinical and radiological outcomes after endovascular treatment of CS-dAVFs.</p><p><strong>Methods: </strong>PubMed, Ovid Medline, Ovid EMBASE, Scopus, and Web of Science were screened for a comprehensive literature review from 1990 to 2020 regarding series of patients treated for CS-dAVF with endovascular approaches. We performed a proportion meta-analysis estimating the pooled rates of each outcome also including data of patients treated in our center.</p><p><strong>Results: </strong>A total of 22 studies reporting 1043 patients and 1066 procedures were included. Chemosis was reported in 559 out of 1043 patients (45.9%), proptosis in 498 (41.5%), and ophthalmoplegia in 344 (23.5%). A transvenous embolization was preferred in 753 cases (63.2%) and coils were used in 712 out of 1066 procedures (57.8%). Overall, 85% (95% confidence interval, CI 69.5-96.1%) of patients had a complete resolution of symptoms, while complications occurred in 7.75% (95% CI 3.82-12.7%) with minimal permanent deficits (0.15%). The mortality rate was 1 out of 1043 patients (< 0.001).</p><p><strong>Conclusion: </strong>A transvenous coiling is the most common endovascular approach for CS-dAVF, achieving a high percentage of radiological and clinical resolution and low complication rates. Transvenous approaches show less complications than transarterial ones, and coils appear safer than liquid embolic agents.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":"32 3","pages":"761-771"},"PeriodicalIF":2.8,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9424140/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39604453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hybrid [¹⁸F]-F-DOPA PET/MRI Interpretation Criteria and Scores for Glioma Follow-up After Radiotherapy.","authors":"Marc Bertaux,&nbsp;Arnaud Berenbaum,&nbsp;Anna-Luisa Di Stefano,&nbsp;Laura Rozenblum,&nbsp;Marine Soret,&nbsp;Sebastien Bergeret,&nbsp;Khé Hoang-Xuan,&nbsp;Laure-Eugenie Tainturier,&nbsp;Brian Sgard,&nbsp;Marie-Odile Habert,&nbsp;Jean-Yves Delattre,&nbsp;Caroline Dehais,&nbsp;Ahmed Idbaih,&nbsp;Nadya Pyatigorskaya,&nbsp;Aurelie Kas","doi":"10.1007/s00062-022-01139-0","DOIUrl":"https://doi.org/10.1007/s00062-022-01139-0","url":null,"abstract":"<p><strong>Objective: </strong>¹⁸F‑fluoro-L‑3,4‑dihydroxyphenylalanine positron emission tomography (F‑DOPA PET) is used in glioma follow-up after radiotherapy to discriminate treatment-related changes (TRC) from tumor progression (TP). We compared the performances of a combined PET and MRI analysis with F‑DOPA current standard of interpretation.</p><p><strong>Methods: </strong>We included 76 consecutive patients showing at least one gadolinium-enhanced lesion on the T1‑w MRI sequence (T1G). Two nuclear medicine physicians blindly analyzed PET/MRI images. In addition to the conventional PET analysis, they looked for F‑DOPA uptake(s) outside T1G-enhanced areas (T1G/PET), in the white matter (WM/PET), for T1G-enhanced lesion(s) without sufficiently concordant F‑DOPA uptake (T1G+/PET), and F‑DOPA uptake(s) away from hemorrhagic changes as shown with a susceptibility weighted imaging sequence (SWI/PET). We measured lesions' F‑DOPA uptake ratio using healthy brain background (TBR) and striatum (T/S) as references, and lesions' perfusion with arterial spin labelling cerebral blood flow maps (rCBF). Scores were determined by logistic regression.</p><p><strong>Results: </strong>53 and 23 patients were diagnosed with TP and TRC, respectively. The accuracies were 74% for T/S, 76% for TBR, and 84% for rCBF, with best cut-off values of 1.3, 3.7 and 1.25, respectively. For hybrid variables, best accuracies were obtained with conventional analysis (82%), T1G+/PET (82%) and SWI/PET (81%). T1G+/PET, SWI/PET and rCBF ≥ 1.25 were selected to construct a 3-point score. It outperformed conventional analysis and rCBF with an AUC of 0.94 and an accuracy of 87%.</p><p><strong>Conclusions: </strong>Our scoring approach combining F‑DOPA PET and MRI provided better accuracy than conventional PET analyses for distinguishing TP from TRC in our patients after radiation therapy.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":"32 3","pages":"735-747"},"PeriodicalIF":2.8,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39606273","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 Dose and Fluoroscopy Time of Diagnostic Angiography in Patients with Spinal Dural Arteriovenous Fistula.","authors":"Yigit Ozpeynirci,&nbsp;Christoph Trumm,&nbsp;Robert Stahl,&nbsp;David Fischer,&nbsp;Thomas Liebig,&nbsp;Robert Forbrig","doi":"10.1007/s00062-021-01130-1","DOIUrl":"https://doi.org/10.1007/s00062-021-01130-1","url":null,"abstract":"<p><strong>Purpose: </strong>Spinal dural arteriovenous fistulas (SDAVFs) represent the most common indication for a spinal angiography. The diagnostic reference level (DRL) for this specific endovascular procedure is still to be determined. This single-center study provides detailed dosimetrics of diagnostic spinal angiography performed in patients with SDAVFs.</p><p><strong>Methods: </strong>Retrospective analysis of all diagnostic spinal angiographies between December 2011 and January 2021. Only patients with an SDAVF who had baseline magnetic resonance angiography (MRA), diagnostic digital subtraction angiography (DSA), treatment and follow-up at this institution were included. Dose area product (DAP, Gy cm²) and fluoroscopy time were compared between preoperative and postoperative angiographies, according to SDAVF locations (common versus uncommon), MRA results at baseline (positive versus negative) and DSA protocols (low-dose, mixed-dose, normal-dose). The 75th percentile of the DAP distribution was used to define the local DRL.</p><p><strong>Results: </strong>A total of 62 spinal angiographies were performed in 25 patients with SDAVF. Preoperative angiographies (30/62, 48%) yielded a significantly higher DAP and longer fluoroscopy time when compared to postoperative angiographies (32/62, 53%) (p < 0.01). The local DRL was 329.41 Gy cm² for a nonspecific (n = 62), 395.59 Gy cm² for a preoperative and 138.6 Gy cm² for a postoperative spinal angiography. Preoperative angiography of uncommonly located SDAVFs yielded a significantly longer fluoroscopy time (p = 0.02). The MRA-based fistula detection had no significant impact on dosimetrics (p > 0.05). A low-dose protocol yielded a 61% reduction of DAP.</p><p><strong>Conclusion: </strong>The results of the present study suggest novel DRLs for spinal angiography in patients with SDAVF. Dedicated low-dose protocols enable radiation dose optimization in these procedures.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":"32 3","pages":"791-797"},"PeriodicalIF":2.8,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9424156/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39793431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Heterogeneity of the Relative Benefits of TICI 2c/3 over TICI 2b50/2b67 : Are there Patients who are less Likely to Benefit?","authors":"Christoph C Kurmann,&nbsp;Adnan Mujanovic,&nbsp;Eike I Piechowiak,&nbsp;Tomas Dobrocky,&nbsp;Felix Zibold,&nbsp;Morin Beyeler,&nbsp;Jan Vynckier,&nbsp;David Seiffge,&nbsp;Thomas R Meinel,&nbsp;Pasquale Mordasini,&nbsp;Marcel Arnold,&nbsp;Urs Fischer,&nbsp;Jan Gralla,&nbsp;Johannes Kaesmacher","doi":"10.1007/s00062-021-01131-0","DOIUrl":"https://doi.org/10.1007/s00062-021-01131-0","url":null,"abstract":"<p><strong>Purpose: </strong>Incomplete reperfusion after mechanical thrombectomy (MT) is associated with a poor outcome. Rescue therapy would potentially benefit some patients with an expanded treatment in cerebral ischemia score (eTICI) 2b50/2b67 reperfusion but also harbors increased risks. The relative benefits of eTICI 2c/3 over eTICI 2b50/67 in clinically important subpopulations were analyzed.</p><p><strong>Methods: </strong>Retrospective analysis of our institutional database for all patients with occlusion of the intracranial internal carotid artery (ICA) or the M1/M2 segment undergoing MT and final reperfusion of ≥eTICI 2b50 (903 patients). The heterogeneity in subgroups of different time metrics, age, National Institutes of Health Stroke Scale (NIHSS), number of retrieval attempts, Alberta Stroke Programme Early CT Score (ASPECTS) and site of occlusion using interaction terms (p_i) was analyzed.</p><p><strong>Results: </strong>The presence of eTICI 2c/3 was associated with better outcomes in most subgroups. Time metrics showed no interaction of eTICI 2c/3 over eTICI 2b50/2b67 and clinical outcomes (onset to reperfusion p_i = 0.77, puncture to reperfusion p_i = 0.65, onset to puncture p_i = 0.63). An eTICI 2c/3 had less consistent association with mRS ≤2 in older patients (>82 years, p_i = 0.038) and patients with either lower NIHSS (≤9) or very high NIHSS (>19, p_i = 0.01). Regarding occlusion sites, the beneficial effect of eTICI 2c/3 was absent for occlusions in the M2 segments (aOR 0.73, 95% confidence interval [CI] 0.33-1.59, p_i = 0.018).</p><p><strong>Conclusion: </strong>Beneficial effect of eTICI 2c/3 over eTICI 2b50/2b67 only decreased in older patients, M2-occlusions and patients with either low or very high NIHSS. Improving eTICI 2b50/2b67 to eTICI 2c/3 in those subgroups may be more often futile.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":"32 3","pages":"817-827"},"PeriodicalIF":2.8,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9424153/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39650714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}