{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T07:00:56Z","timestamp":1769065256670,"version":"3.49.0"},"reference-count":36,"publisher":"BMJ","license":[{"start":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T00:00:00Z","timestamp":1768953600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"unrestricted grants from Covidien Healthcare International Trading (Shanghai), Johnson & John son MedTech, Genesis MedTech (Shanghai), and Shanghai HeartCare Medical Technology","award":["Not applicable"],"award-info":[{"award-number":["Not applicable"]}]},{"name":"Noncommunicable Chronic Diseases-National Science and Technology Major Project","award":["2023ZD0505400"],"award-info":[{"award-number":["2023ZD0505400"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Stroke Vasc Neurol"],"accepted":{"date-parts":[[2026,1,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Infarct volume growth (IVG) correlates with outcomes and may represent a prognostic imaging biomarker in acute ischaemic stroke due to anterior circulation large vessel occlusion (LVO). This study aims to identify factors associated with IVG after mechanical thrombectomy (MT) in patients with large core infarction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This is a post hoc analysis of the Endovascular Therapy in Anterior Circulation Large Vessel Occlusion with a Large Infarct randomised trial. IVG was calculated as final infarct volume minus baseline infarct volume (BIV). The optimal IVG threshold for predicting 90-day favourable outcomes (modified Rankin Scale score 0\u20133) was determined using receiver operating characteristic (ROC) curve analysis, maximising both sensitivity and specificity. Factors associated with IVG were identified using multivariate logistic regression analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 228 included patients, ROC analysis identified an optimal IVG threshold of 105 mL for predicting favourable 90-day outcomes (area under the curve=0.71; specificity=0.85, sensitivity=0.53). Patients were stratified into mild (IVG &lt;105\u2009mL, n=150) and severe (IVG \u2265105\u2009mL, n=78) groups. Multivariate logistic regression identified BIV (OR 1.02, 95% CI 1.00 to 1.03; p&lt;0.01), admission blood glucose (OR 1.20, 95% CI 1.04 to 1.37; p=0.01), time from puncture to recanalisation (OR 1.01, 95% CI 1.00 to 1.02; p=0.049) and recanalisation at 36 hours (\u00b112\u2009hours) (OR 0.19, 95% CI 0.05 to 0.72; p=0.01) as independent factors associated with IVG.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>IVG after MT significantly correlates with clinical outcomes. Identification of modifiable IVG determinants after MT may inform periprocedural management strategies in patients with large infarct due to LVO.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT04551664\">NCT04551664<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/svn-2025-004774","type":"journal-article","created":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T14:55:15Z","timestamp":1769007315000},"page":"svn-2025-004774","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Factors associated with infarct volume growth after mechanical thrombectomy in large core infarction: ANGEL-ASPECT insights"],"prefix":"10.1136","clinical-trial-number":[{"clinical-trial-number":"nct04551664","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3406-7743","authenticated-orcid":false,"given":"Longhui","family":"Zhang","sequence":"first","affiliation":[{"name":"Interventional Neuroradiology, Department of Neurology, Beijing Tiantan Hospital, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-5808-6793","authenticated-orcid":false,"given":"Yufan","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Health Statistics, Capital Medical University, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fangguang","family":"Chen","sequence":"additional","affiliation":[{"name":"Interventional Neuroradiology, Department of Neurology, Beijing Tiantan Hospital, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haoyu","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Peking University First Hospital, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9528-301X","authenticated-orcid":false,"given":"Mohamad","family":"Abdalkader","sequence":"additional","affiliation":[{"name":"Department of Neurology and Radiology, Boston Medical Center, Boston, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-0802-0119","authenticated-orcid":false,"given":"YiYang","family":"Sun","sequence":"additional","affiliation":[{"name":"Capital Medical University, Beijing Tiantan Hospital, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6321-5381","authenticated-orcid":false,"given":"Dapeng","family":"Sun","sequence":"additional","affiliation":[{"name":"Interventional Neuroradiology, Department of Neurology, Beijing Tiantan Hospital, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2810-1685","authenticated-orcid":false,"given":"Thanh","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Department of Neurology and Radiology, Boston Medical Center, Boston, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ying","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Interventional Neuroradiology, Beijing Neurosurgical Institute, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhongrong","family":"Miao","sequence":"additional","affiliation":[{"name":"Neurology and Neuroradiology, Beijing Tiantan Hospital, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2026,1,21]]},"reference":[{"key":"2026012106550530000_svn-2025-004774v1.1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2024.13933"},{"key":"2026012106550530000_svn-2025-004774v1.2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(23)02032-9"},{"key":"2026012106550530000_svn-2025-004774v1.3","doi-asserted-by":"publisher","DOI":"10.1056\/nejmoa2118191"},{"key":"2026012106550530000_svn-2025-004774v1.4","doi-asserted-by":"crossref","DOI":"10.1212\/WNL.0000000000213443","article-title":"Endovascular Thrombectomy for Large Ischemic Core Stroke: A Systematic Review and Meta-Analysis of Randomized Controlled Trials","volume":"104","author":"Liu","year":"2025","journal-title":"Neurology (ECronicon)"},{"key":"2026012106550530000_svn-2025-004774v1.5","doi-asserted-by":"publisher","DOI":"10.1136\/jnis-2022-020025"},{"key":"2026012106550530000_svn-2025-004774v1.6","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1001\/jamaneurol.2018.3661","article-title":"Mediation of the Relationship Between Endovascular Therapy and Functional Outcome by Follow-up Infarct Volume in Patients With Acute Ischemic Stroke","volume":"76","author":"Boers","year":"2019","journal-title":"JAMA Neurol"},{"key":"2026012106550530000_svn-2025-004774v1.7","doi-asserted-by":"crossref","first-page":"1147","DOI":"10.1001\/jamaneurol.2019.2109","article-title":"Outcomes of Endovascular Thrombectomy vs Medical Management Alone in Patients With Large Ischemic Cores: A Secondary Analysis of the Optimizing Patient\u2019s Selection for Endovascular Treatment in Acute Ischemic Stroke (SELECT) Study","volume":"76","author":"Sarraj","year":"2019","journal-title":"JAMA Neurol"},{"key":"2026012106550530000_svn-2025-004774v1.8","doi-asserted-by":"crossref","first-page":"5770","DOI":"10.21037\/qims-23-153","article-title":"Early and late infarct growth rate in ischemic stroke patients after successful endovascular treatment in early time window: correlation of imaging and clinical factors with clinical outcome","volume":"13","author":"Malikova","year":"2023","journal-title":"Quant Imaging Med Surg"},{"key":"2026012106550530000_svn-2025-004774v1.9","doi-asserted-by":"publisher","DOI":"10.1056\/nejmoa2213379"},{"key":"2026012106550530000_svn-2025-004774v1.10","doi-asserted-by":"publisher","DOI":"10.1056\/nejmoa2214403"},{"key":"2026012106550530000_svn-2025-004774v1.11","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A7177"},{"key":"2026012106550530000_svn-2025-004774v1.12","doi-asserted-by":"crossref","first-page":"866","DOI":"10.1161\/STROKEAHA.123.044353","article-title":"What Is a Meaningful Difference When Using Infarct Volume as the Primary Outcome?: Results From the HERMES Database","volume":"55","author":"Rinkel","year":"2024","journal-title":"Stroke"},{"key":"2026012106550530000_svn-2025-004774v1.13","doi-asserted-by":"crossref","first-page":"358","DOI":"10.5853\/jos.2021.00724","article-title":"Mechanical Thrombectomy in Patients with a Large Ischemic Volume at Presentation: Systematic Review and Meta-Analysis","volume":"23","author":"Kerleroux","year":"2021","journal-title":"J Stroke"},{"key":"2026012106550530000_svn-2025-004774v1.14","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.118.021484"},{"key":"2026012106550530000_svn-2025-004774v1.15","doi-asserted-by":"crossref","first-page":"4502","DOI":"10.1007\/s00330-022-09387-x","article-title":"Brush sign and collateral supply as potential markers of large infarct growth after successful thrombectomy","volume":"33","author":"Bani-Sadr","year":"2023","journal-title":"Eur Radiol"},{"key":"2026012106550530000_svn-2025-004774v1.16","first-page":"e444","article-title":"Impact of Repeated Clot Retrieval Attempts on Infarct Growth and Outcome After Ischemic Stroke","volume":"97","author":"Ben Hassen","year":"2021","journal-title":"Neurology (ECronicon)"},{"key":"2026012106550530000_svn-2025-004774v1.17","doi-asserted-by":"crossref","first-page":"105380","DOI":"10.1016\/j.jstrokecerebrovasdis.2020.105380","article-title":"The Effect of Hyperglycemia on Infarct Growth after Reperfusion: An Analysis of the DEFUSE 3 trial","volume":"30","author":"Yaghi","year":"2021","journal-title":"J Stroke Cerebrovasc Dis"},{"key":"2026012106550530000_svn-2025-004774v1.18","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A4969"},{"key":"2026012106550530000_svn-2025-004774v1.19","doi-asserted-by":"crossref","first-page":"2167","DOI":"10.1161\/STROKEAHA.123.043643","article-title":"Infarct Core Growth During Interhospital Transfer For Thrombectomy Is Faster At Night","volume":"54","author":"Seners","year":"2023","journal-title":"Stroke"},{"key":"2026012106550530000_svn-2025-004774v1.20","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.123.044240"},{"key":"2026012106550530000_svn-2025-004774v1.21","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.122.039337"},{"key":"2026012106550530000_svn-2025-004774v1.22","doi-asserted-by":"publisher","DOI":"10.1136\/jnis-2023-020921"},{"key":"2026012106550530000_svn-2025-004774v1.23","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.122.038466"},{"key":"2026012106550530000_svn-2025-004774v1.24","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.115.012364"},{"key":"2026012106550530000_svn-2025-004774v1.25","doi-asserted-by":"publisher","DOI":"10.1136\/neurintsurg-2017-013724"},{"key":"2026012106550530000_svn-2025-004774v1.26","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1161\/STROKEAHA.122.039090","article-title":"Early and Delayed Infarct Growth in Patients Undergoing Mechanical Thrombectomy: A Prospective, Serial MRI Study","volume":"54","author":"Hern\u00e1ndez-P\u00e9rez","year":"2023","journal-title":"Stroke"},{"key":"2026012106550530000_svn-2025-004774v1.27","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A7183"},{"key":"2026012106550530000_svn-2025-004774v1.28","doi-asserted-by":"crossref","unstructured":"Liao NC , Bahr Hosseini M , Saver JL . Clinically important effect sizes for clinical trials using infarct growth reduction as the primary outcome: a systematic review. J Neurointerv Surg 2023. doi:10.1136\/jnis-2023-020850","DOI":"10.1136\/jnis-2023-020850"},{"key":"2026012106550530000_svn-2025-004774v1.29","doi-asserted-by":"publisher","DOI":"10.1038\/nrneurol.2009.231"},{"key":"2026012106550530000_svn-2025-004774v1.30","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.118.023407"},{"key":"2026012106550530000_svn-2025-004774v1.31","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.119.026228"},{"key":"2026012106550530000_svn-2025-004774v1.32","doi-asserted-by":"crossref","first-page":"2431","DOI":"10.1161\/STROKEAHA.125.051789","article-title":"Factors Associated With Early Reocclusion in Recanalized Intracranial Atherosclerotic Occlusion: ANGEL-REBOOT Insights","volume":"56","author":"Li","year":"2025","journal-title":"Stroke"},{"key":"2026012106550530000_svn-2025-004774v1.33","doi-asserted-by":"publisher","DOI":"10.1136\/jnis-2024-022357"},{"key":"2026012106550530000_svn-2025-004774v1.34","doi-asserted-by":"crossref","first-page":"1985","DOI":"10.1161\/STROKEAHA.123.042552","article-title":"Number of Passes of Endovascular Therapy for Stroke With a Large Ischemic Core: Secondary Analysis of RESCUE-Japan LIMIT","volume":"54","author":"Namitome","year":"2023","journal-title":"Stroke"},{"key":"2026012106550530000_svn-2025-004774v1.35","doi-asserted-by":"crossref","unstructured":"Ospel JM , Brown S , Albers GW , et al . Value of 24- to 48-Hour Infarct Volume as a Surrogate for Clinical Outcome in Late-Window Thrombectomy May be Limited: A Post Hoc Analysis of the AURORA Collaboration. Stroke 2025. doi:10.1161\/STROKEAHA.125.052109","DOI":"10.1161\/STROKEAHA.125.052109"},{"key":"2026012106550530000_svn-2025-004774v1.36","doi-asserted-by":"crossref","first-page":"e87","DOI":"10.1136\/jnis-2023-021146","article-title":"Predictors of parenchymal hematoma and clinical outcome after mechanical thrombectomy in patients with large ischemic core due to large vessel occlusion: a retrospective multicenter study","volume":"17","author":"Alexandre","year":"2024","journal-title":"J Neurointerv Surg"}],"container-title":["Stroke and Vascular Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/svn-2025-004774","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T14:55:17Z","timestamp":1769007317000},"score":1,"resource":{"primary":{"URL":"https:\/\/svn.bmj.com\/lookup\/doi\/10.1136\/svn-2025-004774"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,21]]},"references-count":36,"alternative-id":["10.1136\/svn-2025-004774"],"URL":"https:\/\/doi.org\/10.1136\/svn-2025-004774","relation":{},"ISSN":["2059-8688","2059-8696"],"issn-type":[{"value":"2059-8688","type":"print"},{"value":"2059-8696","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,21]]}}}