{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T16:12:43Z","timestamp":1791821563301,"version":"4.3.4"},"reference-count":38,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,5,25]],"date-time":"2024-05-25T00:00:00Z","timestamp":1716595200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Neuroimaging"],"published-print":{"date-parts":[[2024,7]]},"abstract":"Abstract<\/jats:title>Background and Purpose<\/jats:title>Transcranial Doppler (TCD) identifies acute stroke patients with arterial occlusion where treatment may not effectively open the blocked vessel. This study aimed to examine the clinical utility and prognostic value of TCD flow findings in patients enrolled in a multicenter prospective study (CLOTBUST\u2010PRO).<\/jats:p><\/jats:sec>Methods<\/jats:title>Patients enrolled with intracranial occlusion on computed tomography angiography (CTA) who underwent urgent TCD evaluation before intravenous thrombolysis was included in this analysis. TCD findings were assessed using the mean flow velocity (MFV) ratio, comparing the reciprocal ratios of the middle cerebral artery (MCA) depths bilaterally (affected MCA\u2010to\u2010contralateral MCA MFV [aMCA\/cMCA MFV ratio]).<\/jats:p><\/jats:sec>Results<\/jats:title>A total of 222 patients with intracranial occlusion on CTA were included in the study (mean age: 64\u00a0\u00b1\u00a014\u00a0years, 62% men). Eighty\u2010eight patients had M1 MCA occlusions; baseline mean National Institutes of Health Stroke Scale (NIHSS) score was 16, and a 24\u2010hour mean NIHSS score was 10 points. An aMCA\/cMCA MFV ratio of <.6 had a sensitivity of 99%, specificity of 16%, positive predictive value (PV) of 60%, and negative PV of 94% for identifying large vessel occlusion (LVO) including M1 MCA, terminal internal carotid artery, or tandem ICA\/MCA. Thrombolysis in Brain Ischemia scale, with (grade \u22651) compared to without flow (grade 0), showed a sensitivity of 17.1%, specificity of 86.9%, positive PV of 62%, and negative PV of 46% for identifying LVO.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>TCD is a valuable modality for evaluating arterial circulation in acute ischemic stroke patients, demonstrating significant potential as a screening tool for intravenous\/intra\u2010arterial lysis protocols.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jon.13207","type":"journal-article","created":{"date-parts":[[2024,5,25]],"date-time":"2024-05-25T15:07:31Z","timestamp":1716649651000},"page":"430-437","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Validation of the transcranial Doppler rescue criteria for mechanical thrombectomy"],"prefix":"10.1111","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4647-6672","authenticated-orcid":false,"given":"Adnan","family":"Khan","sequence":"first","affiliation":[{"name":"Faculty of Allied Health Sciences Khyber Medical University Peshawar Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maher","family":"Saqqur","sequence":"additional","affiliation":[{"name":"Trillium Health Partners Mississauga Hospital Mississauga Ontario Canada"},{"name":"Department of Medicine University of Toronto Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashfaq","family":"Shuaib","sequence":"additional","affiliation":[{"name":"Division of Neurology Department of Medicine University of Alberta Edmonton Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khurshid","family":"Khan","sequence":"additional","affiliation":[{"name":"Division of Neurology Department of Medicine University of Alberta Edmonton Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8976-5696","authenticated-orcid":false,"given":"Vijay K.","family":"Sharma","sequence":"additional","affiliation":[{"name":"Yong Loo Lin School of Medicine, Division of Neurology National University of Singapore National University Hospital Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandro","family":"Brunser","sequence":"additional","affiliation":[{"name":"Unidad de Neurolog\u00eda Vascular Servicio de Neurolog\u00eda Departamento de Neurolog\u00eda y Psiquiatr\u00eda. 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Facultad de Medicina Cl\u00ednica Alemana Universidad del Desarrollo Santiago Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00fcrgen","family":"Eggers","sequence":"additional","affiliation":[{"name":"Department of Neurology University Hospital Schleswig\u2010Holstein Campus L\u00fcbeck L\u00fcbeck Germany"},{"name":"Department of Neurology Sana Hospital L\u00fcbeck L\u00fcbeck Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Mikulik","sequence":"additional","affiliation":[{"name":"International Clinical Research Center St. Anne's Hospital Brno Czech Republic"},{"name":"Neurology Department Zlin Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6359-0023","authenticated-orcid":false,"given":"Aristeidis H.","family":"Katsanos","sequence":"additional","affiliation":[{"name":"Second Department of Neurology Attikon University Hospital School of Medicine National 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