{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T05:14:02Z","timestamp":1791522842194,"version":"4.3.4"},"reference-count":70,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,9,21]],"date-time":"2025-09-21T00:00:00Z","timestamp":1758412800000},"content-version":"vor","delay-in-days":20,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000057","name":"National Institute of General Medical Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000057","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["5U54GM104942\u201008"],"award-info":[{"award-number":["5U54GM104942\u201008"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Neuroimaging"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Purpose<\/jats:title>\n                    <jats:p>Distal medium\u2010vessel occlusion (DMVO) strokes represent a significant proportion of acute ischemic stroke cases, yet optimal management remains unclear. Prolonged venous transit (PVT), a marker of poor venous outflow, has been associated with worse outcomes in large\u2010vessel occlusion strokes, but its role in DMVO is unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In a retrospective study, consecutive patients with anterior\u2010circulation DMVO, defined as occlusions in the M2\u2013M4 segments of the middle cerebral artery or the anterior cerebral artery. PVT status was determined on pretreatment time\u2010to\u2010maximum perfusion maps by identifying \u226510\u2010s delays in either the posterior superior sagittal sinus or the torcula. Baseline characteristics, imaging findings, and interventions were collected. The primary outcome was a 90\u2010day modified Rankin Scale (mRS) score of 0\u20132.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 77 patients (median age 70 years, 56% female), 18 (23%) had PVT. Median admission National Institutes of Health Stroke Scale scores were 11 (interquartile range, 7\u201315), and intravenous thrombolysis was administered to 35% of patients. Patients with PVT+ were less likely to achieve mRS 0\u20132 at 90 days (adjusted odds ratio, 0.14; 95% confidence interval, 0.02\u20130.85;\n                      <jats:italic>p<\/jats:italic>\n                      = 0.046). There were no significant differences in rates of hemorrhagic transformation or mortality.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>PVT is independently associated with unfavorable functional outcomes in anterior\u2010circulation DMVO. These findings suggest PVT may serve as a prognostic indicator and could inform treatment decisions in this challenging stroke subtype.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jon.70091","type":"journal-article","created":{"date-parts":[[2025,9,22]],"date-time":"2025-09-22T06:50:24Z","timestamp":1758523824000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Prolonged Venous Transit Is Associated With Unfavorable Outcomes in Anterior Circulation Distal Medium Vessel Stroke"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5208-8425","authenticated-orcid":false,"given":"Hamza Adel","family":"Salim","sequence":"first","affiliation":[{"name":"Division of Neuroradiology Department of Radiology Johns Hopkins Medical Center  Baltimore Maryland USA"},{"name":"Department of Neuroradiology MD Anderson Medical Center  Houston Texas 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Department of Radiology Johns Hopkins Medical Center  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aakanksha","family":"Sriwastawa","sequence":"additional","affiliation":[{"name":"Department of Radiology University of Cincinnati  Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Cho","sequence":"additional","affiliation":[{"name":"Division of Neuroradiology Department of Radiology Johns Hopkins Medical Center  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam A.","family":"Dmytriw","sequence":"additional","affiliation":[{"name":"Neuroendovascular Program Massachusetts General Hospital, Harvard University  Boston Massachusetts USA"},{"name":"Neurovascular Centre Departments of Medical Imaging and Neurosurgery St. Michael's Hospital  Toronto Ontario 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