Journal of Stroke & Cerebrovascular Diseases最新文献

{"title":"The frequency of carotid web in cryptogenic stroke and its association with stroke risk factors","authors":"Ekin Öykü Baylam Yirmibeş (Doctor of Medicine) ,&nbsp;Nihat Şengeze (Associate Professor) ,&nbsp;Burak Gürel (Doctor of Medicine)","doi":"10.1016/j.jstrokecerebrovasdis.2025.108295","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108295","url":null,"abstract":"<div><h3>Background</h3><div>The carotid web (CaW) is considered a rare source of cerebral embolism. The aim of this study is to determine the prevalence of CaW, clinical data of CaW cases, risk factors, morphological features of CaW and its relationship with cerebrovascular disease and to contribute to the classification of CaW and the most appropriate treatment approaches in the future.</div></div><div><h3>Methods</h3><div>Angiographic images of 1,520 patients who were evaluated with a preliminary diagnosis of cerebrovascular disease and underwent carotid computed tomographic angiography (CTA) and/or digital subtraction angiography (DSA) at Süleyman Demirel University Medical Faculty Hospital and Isparta City Hospital between 2016 and 2022 were examined. 31 CaW patients were included in the study. Radiological imaging, laboratory findings and clinical information of the patients were evaluated retrospectively.</div></div><div><h3>Results</h3><div>The prevalence of CaW was found to be 2.03 %. 35.5 % of CaW cases were symptomatic and the most common risk factor in these patients were hypertension. The optimum threshold value for CaW length in symptomatic patients was ≥ 2.86 mm. There was a moderate positive linear relationship between CaW length and the degree of CaW stenosis. The optimum threshold value for the degree of web stenosis in symptomatic patients was determined as ≥ 31.33 %.</div></div><div><h3>Conclusion</h3><div>This study showed that some morphological features of CaW increase the risk of stroke. These findings suggest that the evaluation and classification of the morphological features of CaW and the development of risk scoring systems based on these features may be effective in estimating the risk of stroke and planning treatment.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 6","pages":"Article 108295"},"PeriodicalIF":2.0,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143652001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing changes on large cerebral arteries in CADASIL: Preliminary insights from a case-control analysis","authors":"Edgar R. Lopez-Navarro MD ,&nbsp;Silvia V. Mayer MD ,&nbsp;Brenno R. Barreto MD ,&nbsp;Kevin H. Strobino MPH ,&nbsp;Antonio Spagnolo-Allende MD ,&nbsp;Pedro G. Bueno MD ,&nbsp;Kursat Gurel MD ,&nbsp;Khrystyna Kozii MD ,&nbsp;Salwa Rahman MD ,&nbsp;Farid Khasiyev MD ,&nbsp;Jane S. Paulsen PhD ,&nbsp;Jose Gutierrez MD, MPH","doi":"10.1016/j.jstrokecerebrovasdis.2025.108294","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108294","url":null,"abstract":"<div><h3>Introduction</h3><div>Parent large brain arteries are intimately related to their offspring's small arteries. Whether the CADASIL phenotype is confined to small vessels is unclear, and the involvement of large arteries in CADASIL has not been systematically studied.</div></div><div><h3>Methods</h3><div>We conducted a retrospective observational study with patients with CADASIL and randomly selected controls with acute lacunar stroke from the New York-Presbyterian Hospital/Columbia University Irving Medical Center Stroke Registry. We measured the diameters of both groups' basilar artery (BA) and intracranial internal carotid artery (ICA) on T2-weighted images. Z-scores of the arteries were calculated to derive a Brain Arterial Remodeling (BAR) score. We rated cervical ICA tortuosity as 0=no tortuosity, 1 = 45-90° deviation, and 2= &gt;90°. Generalized linear models compared large artery characteristics, adjusting for demographics and clinical variables.</div></div><div><h3>Results</h3><div>We matched 37 patients with CADASIL with 104 controls. Patients with CADASIL were less likely to be Hispanic/Latino (<em>p</em> &lt; 0.001), hypertensive (<em>p</em> &lt; 0.001), or current smokers (<em>p</em> = 0.02) but more likely to have a prior stroke (<em>p</em> &lt; 0.001) than controls. In adjusted models, patients with CADASIL had larger BA diameters than controls (<em>p</em> = 0.002), but there were no differences in the right and left ICA diameters (<em>p</em> = 0.73, <em>p</em> = 0.88). There was a statistical trend for higher cervical ICA tortuosity in patients with CADASIL compared to controls (<em>p</em> = 0.08).</div></div><div><h3>Conclusions</h3><div>Traditionally considered a small-vessel disease, patients with CADASIL have larger BA diameters and possibly higher cervical ICA tortuosity than controls. Whether these changes are part of the NOTCH-3 mutation phenotype or influence the clinical course is uncertain but should be further investigated.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 6","pages":"Article 108294"},"PeriodicalIF":2.0,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Moyamoya disease: Understanding patient experiences through thematic analysis of Instagram, TikTok, and Twitter posts","authors":"Neo Y. Hou ,&nbsp;Avi A. Gajjar ,&nbsp;Eli Hou ,&nbsp;Arnav Barpujari ,&nbsp;Mohamed M. Salem MD, MPH ,&nbsp;Georgios Sioutas MD ,&nbsp;Visish M. Srinivasan MD ,&nbsp;Brian T. Jankowitz MD ,&nbsp;Jan-Karl Burkhardt MD","doi":"10.1016/j.jstrokecerebrovasdis.2025.108293","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108293","url":null,"abstract":"<div><h3>Introduction</h3><div>Physicians aim to provide optimal care, considering patient experiences and satisfaction. Traditional in-clinic surveys assessing surgical experiences face numerous limitations, including response bias, and inadequate inclusion of diverse demographics. Social media is an emerging platform for patients to share their healthcare experiences, providing an alternative method for gathering patient feedback. This study explores the prevalent themes of moyamoya disease experiences shared on social media.</div></div><div><h3>Methods</h3><div>Posts containing \"#moyamoya\" and \"#moyamoyawarrior\" from Instagram, TikTok, and Twitter were analyzed. Posts unrelated to direct patient experiences were excluded. Relevant posts were categorized by themes and analyzed based on the platform, gender, and identity of the poster (patient or someone else). Chi-squared tests were used to determined significance of theme prevalence.</div></div><div><h3>Results</h3><div>Of the 1,005 social media posts analyzed, 63.8 % were by patients, and 75.0 % were by females. Most patients (83.0 %) had undergone one surgery. Instagram posts most often focused on Recovery/Rehabilitation (69.7 %), Survival (66.7 %), and Spreading Positivity (45.8 %), while TikTok posts more frequently discussed Survival (97.2 %), Recovery/Rehabilitation (81.3 %), and Spreading Positivity (84.1 %) (<em>p</em> &lt; 0.001). Females were less likely to post on these themes than males, who discussed religious topics more frequently (<em>p</em> = 0.029). Patients discussed appearance (<em>p</em> &lt; 0.001), resiliency (<em>p</em> = 0.002), and quality of life (<em>p</em> = 0.014) more than their loved ones.</div></div><div><h3>Conclusion</h3><div>This study demonstrates social media's use among moyamoya patients, and can supplement traditional methods of obtaining patient feedback. Despite limitations, leveraging social media can enhance understanding patient needs, ultimately improving care quality for Moyamoya disease patients.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 6","pages":"Article 108293"},"PeriodicalIF":2.0,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143652000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing the effectiveness and safety of direct oral anticoagulants and warfarin in patients with cerebral venous thrombosis: A real-world study","authors":"Jheng-yan Wu ,&nbsp;Chih-cheng Lai ,&nbsp;Huey-Juan Lin ,&nbsp;Kuan-Hsien Lu ,&nbsp;Wan-Hsuan Hsu ,&nbsp;Ting-ying Chu","doi":"10.1016/j.jstrokecerebrovasdis.2025.108290","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108290","url":null,"abstract":"<div><h3>Background</h3><div>Cerebral venous thrombosis (CVT), a rare stroke variant, poses treatment challenges, especially in young individuals. While guidelines recommend heparin followed by warfarin, warfarin has limitations. Direct oral anticoagulants (DOACs) offer a potential alternative, but evidence on their use in CVT management is limited. The TriNetX study aimed to provide real-world insights into DOAC efficacy and safety for CVT.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study utilizing data from TriNetX to identify patients with CVT. Propensity score matching (PSM) was used to balance the covariates between patients receiving DOACs and those receiving warfarin. The primary outcome was recurrent CVT, with secondary outcomes including intracerebral hemorrhage and all-cause mortality.</div></div><div><h3>Results</h3><div>Among 1,507 patients with CVT, PSM generated 551 matched individuals in both the study and control groups. The study group that received DOACs exhibited a lower risk of CVT recurrence (Hazard Ratio [HR], 0.77; 95 % Confidence Interval [CI], 0.628–0.97) and a higher 360-day event-free survival rate (p &lt; 0.001). Subgroup analyses revealed significantly reduced recurrent CVT risk in the study group, particularly among females (HR, 0.67; 95 % CI, 0.50-0.89), individuals aged 41–64 years (HR, 0.52; 95 % CI, 0.35–0.75), and patients with normal weight (HR, 0.65; 95 % CI, 0.50–0.84). Moreover, recipients of DOACs had a lower risk of intracerebral hemorrhage (HR, 0.62; 95 % CI, 0.43–0.91) and comparable all-cause mortality (HR, 1.03; 95 % CI, 0.67-1.59).</div></div><div><h3>Conclusions</h3><div>This study underscores the potential of DOACs as a promising treatment for CVT, demonstrating reduced recurrence and intracerebral hemorrhage risks with comparable all-cause mortality.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 6","pages":"Article 108290"},"PeriodicalIF":2.0,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to “ROTEM and von Willebrand Factor in COVID patients presenting with acute ischemic stroke: A case series: ROTEM and von Willebrand Factor in COVID-19 Related Stroke” [Journal of Stroke and Cerebrovascular Diseases, Volume 33 (11), 2024 Nov 1, p.107894]","authors":"Tamara Strohm","doi":"10.1016/j.jstrokecerebrovasdis.2025.108275","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108275","url":null,"abstract":"","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 5","pages":"Article 108275"},"PeriodicalIF":2.0,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143631041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the editor regarding “Association of antihypertensive drug target genes with stroke subtypes: A Mendelian randomization study”","authors":"Zhe Jiang BD,&nbsp;Zijian Wang BD","doi":"10.1016/j.jstrokecerebrovasdis.2025.108289","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108289","url":null,"abstract":"","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 6","pages":"Article 108289"},"PeriodicalIF":2.0,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143631042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"IRE1α/TRAF2/NF-κB pathway promotes apoptosis via regulating inflammatory cytokines and aggravates brain injury after SAH","authors":"Bin Liu ,&nbsp;Chao Zhu ,&nbsp;Linzhi Dai ,&nbsp;Lei Zhang ,&nbsp;Hui Xu ,&nbsp;Kunhao Ren ,&nbsp;Hao Zhang ,&nbsp;Ganggang Wang ,&nbsp;Weidong Tian ,&nbsp;Dong Zhao","doi":"10.1016/j.jstrokecerebrovasdis.2025.108288","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108288","url":null,"abstract":"<div><h3>Objectives</h3><div>To investigate the effect of IRE1α/TRAF2/NF-κB pathway on early brain injury.</div></div><div><h3>Methods</h3><div>An endovascular puncture model of subarachnoid hemorrhage (SAH) was developed and SAH grading was performed. The following groups of experimental animals were randomly assigned: Blank group, Sham group, SAH+ DMSO group, SAH+STF-083010(IRE1α inhibitor) group, and SAH+BAY11‐7082(NF-κB inhibitor) group. Neurological <em>deficits</em> were assessed in the animal models using a modified Garcia score. The expression of IRE1α, GRP78, TRAF2, NF-κB, and caspase3 was measured using western blot analysis. The concentrations of TNF-α, IL-1β and IL-6 were evaluated with ELISA kits. An analysis of neuronal apoptosis was performed using TUNEL staining.</div></div><div><h3>Results</h3><div>The neurological deficits, <em>expression of IRE1α/TRAF2/NF-κB axis and its related proteins,</em> inflammatory cytokines and apoptosis were increased after SAH, whereas their expressions were suppressed since the inhibition of the IRE1α/TRAF2/NF-κB signal pathway. Moreover, correlation analysis showed that TNF-α, IL-1β and IL-6 were positively correlated with apoptosis.</div></div><div><h3>Conclusions</h3><div>The <em>IRE1α/TRAF2/NF-κB</em> signal pathway was activated and promoted apoptosis by promoting the expression of inflammatory cytokines after SAH.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 6","pages":"Article 108288"},"PeriodicalIF":2.0,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of bias assessment of post-stroke mortality machine learning predictive models: Systematic review","authors":"Nicole Maria Radley ,&nbsp;Ian Soh ,&nbsp;Abdelrahman M. Saad ,&nbsp;Milindu Wickramarachchi ,&nbsp;Amelia Dawson ,&nbsp;Jeremy Ng Chieng Hin ,&nbsp;Asad Ali ,&nbsp;Abhrajit Giri ,&nbsp;Alicia Kwan ,&nbsp;Osama Elzankaly ,&nbsp;Mariam Tarek Desouki ,&nbsp;Mohamed S Jabal ,&nbsp;Abdelrahman M Hamouda ,&nbsp;Sherief Gozy ,&nbsp;David F Kallmes","doi":"10.1016/j.jstrokecerebrovasdis.2025.108291","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108291","url":null,"abstract":"<div><h3>Background</h3><div>Stroke is a major cause of mortality and permanent disability worldwide. Precise prediction of post-stroke mortality is essential for guiding treatment decisions and rehabilitation planning. The ability of Machine learning models to process large amounts of data, offer a promising alternative for improving mortality prediction in stroke patients. In this review, we aim to evaluate the risk of bias in different machine learning models used for predicting post-stroke mortality.</div></div><div><h3>Methods</h3><div>This review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Critical Appraisal and Data Extraction for Systematic Reviews of Prediction Modelling Studies (CHARMS). Relevant articles were retrieved from Cochrane Library, Scopus, PubMed, and Web of Science databases.</div></div><div><h3>Results</h3><div>A total of 9 studies were included, with an aggregate patient population of 669,424. Six studies used publicly available datasets, and four used hospital data with a follow up duration ranging from 7 days to 18 months. The range of area under the curve (AUC) for mortality prediction across the studies ranged from 0.81 to 0.95. All studies were determined to have a high overall risk of bias.</div></div><div><h3>Conclusion</h3><div>Machine learning models demonstrated great potential in predicting post-stroke mortality. However, implementation of these models in clinical practice is limited by high risk of bias. Future studies should focus on reducing this bias and enhancing the applicability of these models to improve the reliability of stroke mortality predictions.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 6","pages":"Article 108291"},"PeriodicalIF":2.0,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in stroke mortality in Latin America and the Caribbean from 1997 to 2020 and predictions to 2035: An analysis of gender, and geographical disparities","authors":"J. Smith Torres-Roman MD,MSc ,&nbsp;Carlos Quispe-Vicuña MD ,&nbsp;Alexandra Benavente-Casas MD ,&nbsp;Dante Julca-Marin MS ,&nbsp;Wagner Rios-Garcia MS ,&nbsp;Mabel R. Challapa-Mamani MS ,&nbsp;Lita del Rio-Muñiz MD ,&nbsp;Jorge Ybaseta-Medina MD, PhD","doi":"10.1016/j.jstrokecerebrovasdis.2025.108286","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108286","url":null,"abstract":"<div><h3>Background</h3><div>Stroke is a leading cause of death and disability globally, with significant public health implications. In Latin America, while mortality rates have declined, the number of stroke cases has increased due to prevalent risk factors like high blood pressure and obesity. Unlike Europe, recent trends in stroke mortality in this region remain underreported.</div></div><div><h3>Objective</h3><div>This study evaluates stroke mortality rates in Latin America Latin American and Caribbean (LAC) countries from 1997 to 2020 and predictions to 2035.</div></div><div><h3>Methods</h3><div>This ecological observational study utilized mortality data from the World Health Organization database. Trends were analyzed using Joinpoint regression to evaluate the annual percent change (APC) by sex and country. Predicted mortality rates through 2035 were calculated using the Nordpred package in R. Changes in stroke mortality were assessed by disentangling the effects of population growth, aging, and risk factor modifications, based on age-specific rates and projections. Results were presented as absolute case numbers and relative percentages.</div></div><div><h3>Results</h3><div>From 1997 to 2020, twelve countries presented significant reductions in stroke mortality rates for men in LAC, the main ones being Chile (−4.2 %), El Salvador (−4.2 %), and Puerto Rico (−4.0 %). Thirteen countries reported a reduction in their mortality for women, mainly in Puerto Rico (−4.3 %), Chile (−3.7 %), Argentina, El Salvador, and Uruguay (−3.5 %). By 2035, an increase in deaths among men and women is expected, mainly due to the increase in population structure and size. However, a decrease in the mortality rate will be reported, mainly due to the reduction of risk factors.</div></div><div><h3>Conclusion</h3><div>Our final findings show a reduction in stroke mortality trends in LAC countries between 1997 and 2020, due to creating public awareness about vascular risk factors by authorities and the implementation of effective health policies. By 2035, an overall increase in mortality is expected, mainly due to population change in each country.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 6","pages":"Article 108286"},"PeriodicalIF":2.0,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differences in door-to-device times in a retrospective cohort of patients with ischemic stroke who received CTA only or CTA and CTP imaging","authors":"Jason W. Tarpley MD, PhD ,&nbsp;Horia Marginean MD, MS ,&nbsp;Weston Anderson BA ,&nbsp;Kamila Szweda ,&nbsp;Reza Bavarsad Shahripour ,&nbsp;Tamela Stuchiner MA","doi":"10.1016/j.jstrokecerebrovasdis.2025.108272","DOIUrl":"10.1016/j.jstrokecerebrovasdis.2025.108272","url":null,"abstract":"<div><div>Background: In the treatment of acute ischemic stroke, there are differing views about the utility of computerized tomography perfusion (CTP). Two approaches are employed depending on hospital preference. The first approach is to perform non-contrast computed tomography (CT) scans followed by vascular imaging with computed tomography angiography (CTA) for patients arriving within 6 h of last known well. In the first approach, CTP is reserved for patients who arrive 6-24 h after last known well. The second approach is to utilize both CTA and CTP regardless of the time window in which the patient presents. In this study, we sought to answer whether patients triaged with CTP and CTA had increased door-to-device times compared to those only triaged with CTA.</div><div>Methods: We investigated a retrospective cohort of 1,357 patients with ischemic stroke who received endovascular therapy (EVT) and were triaged with CTA only or CTA and CTP. Patients were stratified by when they arrived at the hospital (&lt;6 h and 6-24 h from last known well). Linear mixed-effects models (LMM) were used to investigate the association between door-to-device times and CTA/CTP usage.</div><div>Results: Our results showed that using CTP and CTA was not associated with increased time to treat compared to CTA alone. There was no increase in time from door to device in patients presenting within 6 h. Furthermore, for patients who arrived 6-24 h of last known well, the use of CTP and CTA was associated with an accelerated time to treatment with EVT.</div><div>Conclusions: CTA and CTP usage was not associated with added time costs with respect to door-to-device in this patient cohort. Our results are consistent with other data showing that radiologists have faster read times when given both CTP and CTA. It is noteworthy that the majority of EVT patients in our dataset (70.6 %) presented in the &lt;6-hour time window.</div></div>","PeriodicalId":54368,"journal":{"name":"Journal of Stroke & Cerebrovascular Diseases","volume":"34 5","pages":"Article 108272"},"PeriodicalIF":2.0,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143611681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}