{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T00:40:37Z","timestamp":1773967237254,"version":"3.50.1"},"reference-count":23,"publisher":"BMJ","issue":"4","funder":[{"name":"Grant of the Italian Ministry of Health"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J NeuroIntervent Surg"],"accepted":{"date-parts":[[2017,7,14]]},"published-print":{"date-parts":[[2018,4]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Few data exist on malignant middle cerebral artery infarction (MMI) among patients with acute ischemic stroke (AIS) after endovascular treatment (ET). Numerous predictors of MMI evolution have been proposed, but a comprehensive research of patients undergoing ET has never been performed. Our purpose was to find a practical model to determine robust predictors of MMI in patients undergoing ET.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Patients from a prospective single-center database with AIS secondary to large intracranial vessel occlusion of the anterior circulation, treated with ET, were retrospectively analyzed. We investigated demographic, clinical, and radiological data. Multivariate regression analysis was used to identify clinical and imaging predictors of MMI.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>98 patients were included in the analysis, 35 of whom developed MMI (35.7%). No differences in the rate of successful reperfusion and time from stroke onset to reperfusion were found between the MMI and non-MMI groups. The following parameters were identified as independent predictors of MMI: systolic blood pressure (SBP) on admission (p=0.008), blood glucose (BG) on admission (p=0.024), and the CTangiography (CTA) Alberta Stroke Program Early CT Score (ASPECTS) (p=0.001). A scoreof \u22645 in CTA ASPECTS was the best cut-off to predict MMI evolution (sensitivity 46%; specificity 97%; positive predictive value 78%; negative predictive value 65%).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>in our study a clinical and radiological features-based model was strongly predictive of MMI evolution in AIS. High SBP and BG on admission and, especially, a CTA ASPECTS \u22645\u2009may help to make decisions quickly, regardless of time to treatment and successful reperfusion.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/neurintsurg-2017-013224","type":"journal-article","created":{"date-parts":[[2017,8,10]],"date-time":"2017-08-10T20:50:12Z","timestamp":1502398212000},"page":"340-344","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":34,"title":["Pretreatment predictors of malignant evolution in patients with ischemic stroke undergoing mechanical thrombectomy"],"prefix":"10.1136","volume":"10","author":[{"given":"Alessandro","family":"Davoli","sequence":"first","affiliation":[{"name":"Department of Neuroscience, Comprehensive Stroke Center, University of Tor Vergata, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caterina","family":"Motta","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Comprehensive Stroke Center, University of Tor Vergata, Rome, Italy"},{"name":"Santa Lucia Foundation, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giacomo","family":"Koch","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Comprehensive Stroke Center, University of Tor Vergata, Rome, Italy"},{"name":"Santa Lucia Foundation, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marina","family":"Diomedi","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Comprehensive Stroke Center, University of Tor Vergata, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simone","family":"Napolitano","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Comprehensive Stroke Center, University of Tor Vergata, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angela","family":"Giordano","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Comprehensive Stroke Center, University of Tor Vergata, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marta","family":"Panella","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Comprehensive Stroke Center, University of Tor Vergata, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniele","family":"Morosetti","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Imaging, Interventional Radiology and Neuroradiology, University of Tor Vergata, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sebastiano","family":"Fabiano","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Imaging, Interventional Radiology and Neuroradiology, University of Tor Vergata, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberto","family":"Floris","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Imaging, Interventional Radiology and Neuroradiology, University of Tor Vergata, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberto","family":"Gandini","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Imaging, Interventional Radiology and Neuroradiology, University of Tor Vergata, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabrizio","family":"Sallustio","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Comprehensive Stroke Center, University of Tor Vergata, Rome, Italy"},{"name":"Santa Lucia Foundation, Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2017,8,10]]},"reference":[{"key":"2025092912052651000_10.4.340.1","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.1996.00550040037012"},{"key":"2025092912052651000_10.4.340.2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(07)70036-4"},{"key":"2025092912052651000_10.4.340.3","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.110.591362"},{"key":"2025092912052651000_10.4.340.4","doi-asserted-by":"publisher","DOI":"10.1002\/ana.22125"},{"key":"2025092912052651000_10.4.340.5","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.111.619734"},{"key":"2025092912052651000_10.4.340.6","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A2985"},{"key":"2025092912052651000_10.4.340.7","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.115.010608"},{"key":"2025092912052651000_10.4.340.8","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.20.7.864"},{"key":"2025092912052651000_10.4.340.9","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.24.1.35"},{"key":"2025092912052651000_10.4.340.10","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.19.5.604"},{"key":"2025092912052651000_10.4.340.11","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(00)02237-6"},{"key":"2025092912052651000_10.4.340.12","doi-asserted-by":"crossref","unstructured":"Sallustio F , Motta C , Pizzuto S , et al . CT Angiography ASPECTS Predicts Outcome Much Better Than Noncontrast CT in Patients with Stroke Treated Endovascularly. AJNR Am J Neuroradiol 2017.doi:10.3174\/ajnr.A5264","DOI":"10.3174\/ajnr.A5264"},{"key":"2025092912052651000_10.4.340.13","doi-asserted-by":"publisher","DOI":"10.1002\/ana.21130"},{"key":"2025092912052651000_10.4.340.14","first-page":"1789","article-title":"Angiographic assessment of pial collaterals as a prognostic indicator following intra-arterial thrombolysis for acute ischemic stroke","volume":"26","author":"Christoforidis","year":"2005","journal-title":"Am J Neuroradiol"},{"key":"2025092912052651000_10.4.340.15","doi-asserted-by":"crossref","unstructured":"Sallustio F , Motta C , Pizzuto S , et al . CT angiography-based collateral flow and time to reperfusion are strong predictors of outcome in endovascular treatment of patients with stroke. J Neurointerv Surg 2016 (Published Online First:\u00a023 September 2016.).doi:10.1136\/neurintsurg-2016-012628","DOI":"10.1136\/neurintsurg-2016-012628"},{"key":"2025092912052651000_10.4.340.16","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(98)08020-9"},{"key":"2025092912052651000_10.4.340.17","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000082721.62796.09"},{"key":"2025092912052651000_10.4.340.18","doi-asserted-by":"publisher","DOI":"10.1136\/neurintsurg-2016-012386"},{"key":"2025092912052651000_10.4.340.19","doi-asserted-by":"publisher","DOI":"10.3171\/2011.1.JNS10884"},{"key":"2025092912052651000_10.4.340.20","doi-asserted-by":"publisher","DOI":"10.1159\/000223436"},{"key":"2025092912052651000_10.4.340.21","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1007\/s00234-016-1652-7","article-title":"Alberta Stroke\u00a0Program Early CT Score applied to CT angiography source images is a strong predictor of futile recanalization in acute ischemic stroke","volume":"58","author":"Kawiorski","year":"2016","journal-title":"Neuroradiology"},{"key":"2025092912052651000_10.4.340.22","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.113.004072"},{"key":"2025092912052651000_10.4.340.23","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.30.2.287"}],"container-title":["Journal of NeuroInterventional Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/neurintsurg-2017-013224","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T19:05:32Z","timestamp":1759172732000},"score":1,"resource":{"primary":{"URL":"https:\/\/jnis.bmj.com\/lookup\/doi\/10.1136\/neurintsurg-2017-013224"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,8,10]]},"references-count":23,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2018,3,19]]},"published-print":{"date-parts":[[2018,4]]}},"alternative-id":["10.1136\/neurintsurg-2017-013224"],"URL":"https:\/\/doi.org\/10.1136\/neurintsurg-2017-013224","relation":{},"ISSN":["1759-8478","1759-8486"],"issn-type":[{"value":"1759-8478","type":"print"},{"value":"1759-8486","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,8,10]]}}}