{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T02:51:58Z","timestamp":1772160718320,"version":"3.50.1"},"reference-count":21,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,5,9]],"date-time":"2023-05-09T00:00:00Z","timestamp":1683590400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Neuroimaging"],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Purpose<\/jats:title>\n                    <jats:p>We aimed to investigate the relationship between the degree and location of vertebrobasilar stenosis and quantitative magnetic resonance angiography (QMRA) distal flow.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We retrospectively reviewed patients who presented with acute ischemic stroke with \u226550% stenosis of the extracranial or intracranial vertebral or basilar arteries, and QMRA performed within 1\u00a0year of stroke. Standardized techniques were used to measure stenosis and to dichotomize vertebrobasilar distal flow status. Patients were grouped based on the involved artery and the severity of disease. All\n                      <jats:italic>p<\/jats:italic>\n                      \u2010values were calculated using chi\u2010squared analysis and Fisher exact test with statistical significance defined as\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a0.05.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Sixty\u2010nine patients met study inclusion, consisting of 31 with low distal flow and 38 with normal distal flow. The presence of severe stenosis or occlusion was 100% sensitive, but only 47% predictive and 26% specific of a low distal flow state. Bilateral vertebral disease was only 55% sensitive but was 71% predictive and 82% specific of a low\u2010flow state and was five times and nearly three times more likely to result in a low\u2010flow state compared to unilateral vertebral disease (14%) and isolated basilar disease (28%), respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Severe stenosis of \u226570% may mark the minimal threshold required to cause hemodynamic insufficiency in the posterior circulation, but nearly half of these patients may remain hemodynamically sufficient. Bilateral vertebral stenosis resulted in a fivefold increase in QMRA low distal flow status compared to unilateral vertebral disease. These results may have implications in the design of future treatment trials of intracranial atherosclerotic disease.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jon.13112","type":"journal-article","created":{"date-parts":[[2023,5,10]],"date-time":"2023-05-10T15:13:03Z","timestamp":1683731583000},"page":"598-605","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Association between the degree of vertebrobasilar stenosis, location, infarction pattern, and QMRA flow state"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7408-4233","authenticated-orcid":false,"given":"Ahmad A.","family":"Ballout","sequence":"first","affiliation":[{"name":"Department of Neurology Donald and Barbara Zucker School of Medicine at Hofstra\/Northwell  Hempstead New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brendan","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Neurology Donald and Barbara Zucker School of Medicine at Hofstra\/Northwell  Hempstead New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0939-3974","authenticated-orcid":false,"given":"Seok Yoon","family":"Oh","sequence":"additional","affiliation":[{"name":"Department of Neurology Donald and Barbara Zucker School of Medicine at Hofstra\/Northwell  Hempstead New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen","family":"Black","sequence":"additional","affiliation":[{"name":"Department of Radiology Donald and Barbara Zucker School of Medicine at Hofstra\/Northwell  Hempstead New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Panagiotis","family":"Sideras","sequence":"additional","affiliation":[{"name":"Department of Radiology Columbia University Irving Medical Center at NewYork\u2010Presbyterian Hospital  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rohan","family":"Arora","sequence":"additional","affiliation":[{"name":"Department of Neurology Donald and Barbara Zucker School of Medicine at Hofstra\/Northwell  Hempstead New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0031-1004","authenticated-orcid":false,"given":"Shadi","family":"Yaghi","sequence":"additional","affiliation":[{"name":"Department of Neurology Brown University  Providence Rhode Island USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey M.","family":"Katz","sequence":"additional","affiliation":[{"name":"Department of Neurology Donald and Barbara Zucker School of Medicine at Hofstra\/Northwell  Hempstead New York USA"},{"name":"Department of Radiology Donald and Barbara Zucker School of Medicine at Hofstra\/Northwell  Hempstead New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard B.","family":"Libman","sequence":"additional","affiliation":[{"name":"Department of Neurology Donald and Barbara Zucker School of Medicine at Hofstra\/Northwell  Hempstead New York 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