{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T23:18:08Z","timestamp":1791155888091,"version":"4.1.0"},"reference-count":29,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2013,11,18]]},"abstract":"\n Background<\/jats:title>\n \n The early identification of patients who are unlikely to respond to intravenous recombinant tissue plasminogen activator (\n IV<\/jats:styled-content>\n \u2010\n tPA<\/jats:styled-content>\n ) could help select candidates for additional intra\u2010arterial therapy or add\u2010on antithrombotic drugs during the acute stage of stroke. Given that very early neurological improvement (\n VENI<\/jats:styled-content>\n ) is a reliable surrogate of early recanalization, we assessed the clinical and magnetic resonance imaging predictors of lack of\n VENI<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n We reviewed consecutive ischemic stroke patients with middle cerebral artery occlusion and treated within 4.5\u00a0hours by\n IV<\/jats:styled-content>\n \u2010\n tPA<\/jats:styled-content>\n between 2003 and 2012 in our center, where magnetic resonance imaging is systematically implemented as first\u2010line diagnostic workup. Lack of\n VENI<\/jats:styled-content>\n was defined as a <40% decrease in baseline National Institutes of Health Stroke Scale (\n NIHSS<\/jats:styled-content>\n ) score 1\u00a0hour after start of\n IV<\/jats:styled-content>\n \u2010\n tPA<\/jats:styled-content>\n . Poor outcome was defined as a 3\u2010month modified\n R<\/jats:styled-content>\n ankin scale \u22652. Associations between lack of\n VENI<\/jats:styled-content>\n and potential determinants were assessed in logistic regression models. In all, 186 patients were included (median baseline\n NIHSS<\/jats:styled-content>\n score, 16; median onset to treatment time, 155\u00a0minutes). One hundred forty\u2010three patients (77%) had no\n VENI<\/jats:styled-content>\n . The variables significantly associated with lack of\n VENI<\/jats:styled-content>\n in multivariable analysis were baseline\n NIHSS<\/jats:styled-content>\n (\n OR<\/jats:styled-content>\n , 1.08; 95%\n CI<\/jats:styled-content>\n , 1.01 to 1.16 per 1\u2010point increase;\n P<\/jats:italic>\n =0.03), onset to treatment time >120\u00a0minutes (\n OR<\/jats:styled-content>\n , 2.94; 95% CI, 1.31 to 6.63;\n P<\/jats:italic>\n =0.009) and diffusion weighted imaging\u2014Alberta Stroke Programme Early CT Score \u22645 (\n OR<\/jats:styled-content>\n , 3.60; 95%\n CI<\/jats:styled-content>\n , 1.14 to 11.35;\n P<\/jats:italic>\n =0.03). Patients without\n VENI<\/jats:styled-content>\n were more likely to have a modified Rankin Scale \u22652 than those without\n VENI<\/jats:styled-content>\n (68% versus 24%;\n OR<\/jats:styled-content>\n , 5.01; 95%\n CI<\/jats:styled-content>\n , 2.12 to 11.82) and less likely to have recanalization after 24\u00a0hours (\n OR<\/jats:styled-content>\n , 0.41; 95%\n CI<\/jats:styled-content>\n , 0.19 to 0.88).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Lack of\n VENI<\/jats:styled-content>\n provides an early estimate of 3\u2010month outcome and recanalization after\n IV<\/jats:styled-content>\n \u2010\n tPA<\/jats:styled-content>\n . Baseline\n NIHSS<\/jats:styled-content>\n , onset to treatment time, and diffusion weighted imaging\u2014Alberta Stroke Programme Early CT Score could help to predict lack of\n VENI<\/jats:styled-content>\n and, in turn, might help early selection of candidates for complementary reperfusion strategies.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.113.000511","type":"journal-article","created":{"date-parts":[[2013,12,6]],"date-time":"2013-12-06T04:03:27Z","timestamp":1386302607000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":18,"title":["Clinical and Magnetic Resonance Imaging Predictors of Very Early Neurological Response to Intravenous Thrombolysis in Patients With Middle Cerebral Artery Occlusion"],"prefix":"10.1161","volume":"2","author":[{"given":"Marion","family":"Apoil","sequence":"first","affiliation":[{"name":"Universit\u00e9 de Caen Basse Normandie, INSERM U919, GIP Cyc\u00e9ron, CHU C\u00f4te de Nacre, Caen, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guillaume","family":"Turc","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Paris Descartes Sorbonne Paris Cit\u00e9, INSERM UMR S894, H\u00f4pital Sainte\u2010Anne, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie","family":"Tisserand","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Paris Descartes Sorbonne Paris Cit\u00e9, INSERM UMR S894, H\u00f4pital Sainte\u2010Anne, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Calvet","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Paris Descartes Sorbonne Paris Cit\u00e9, INSERM UMR S894, H\u00f4pital Sainte\u2010Anne, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivier","family":"Naggara","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Paris Descartes Sorbonne Paris Cit\u00e9, INSERM UMR S894, H\u00f4pital Sainte\u2010Anne, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Val\u00e9rie","family":"Domigo","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Paris Descartes Sorbonne Paris Cit\u00e9, INSERM UMR S894, H\u00f4pital Sainte\u2010Anne, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean\u2010Claude","family":"Baron","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Paris Descartes Sorbonne Paris Cit\u00e9, INSERM UMR S894, H\u00f4pital Sainte\u2010Anne, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Oppenheim","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Paris Descartes Sorbonne Paris Cit\u00e9, INSERM UMR S894, H\u00f4pital Sainte\u2010Anne, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuel","family":"Touz\u00e9","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Paris Descartes Sorbonne Paris Cit\u00e9, INSERM UMR S894, H\u00f4pital Sainte\u2010Anne, Paris, France"},{"name":"Universit\u00e9 de Caen Basse Normandie, INSERM U919, GIP Cyc\u00e9ron, CHU C\u00f4te de Nacre, Caen, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/STR.0b013e318284056a"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1038\/jcbfm.2011.127"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000258112.14918.24"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199512143332401"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0804656"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)60491-6"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(08)61339-2"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-154-4-201102150-00306"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(09)70182-6"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.111.635029"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.111.625574"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMe1215730"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.106.651026"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.111.613273"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.109.571562"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(00)02237-6"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.2004.059261"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.107.510917"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.111.000127"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3181eccf78"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.112.661009"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.110.606194"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000113737.58014.B4"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1001\/archneurol.2010.265"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000015556.48283.74"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1007\/s13760-012-0155-5"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000055940.00316.6B"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.112.675470"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.113.001026"}],"container-title":["Journal 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