{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T12:26:44Z","timestamp":1791289604205,"version":"4.3.0"},"reference-count":8,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2013,12]]},"abstract":"<jats:sec>\n            <jats:title>Background and Purpose\u2014<\/jats:title>\n            <jats:p>Thin-section noncontrast computed tomography images can be used to measure hyperdense clot length in acute ischemic stroke. Clots \u22658 mm have a very low probability of intravenous tissue-type plasminogen activator recanalization and hence may benefit from a bridging intra-arterial approach. To understand the prevalence of such clots, we sought to determine the distribution and predictors of clot lengths in consecutive anterior circulation proximal artery occlusions.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods\u2014<\/jats:title>\n            <jats:p>Of 623 consecutive patients with acute ischemic stroke, 53 met inclusion criteria: presentation &lt;8 hours from onset; intracranial internal carotid artery-terminus or proximal-middle cerebral artery occlusion; admission thin-slice noncontrast computed tomography (\u22642.5 mm); and no intravenous tissue-type plasminogen activator pretreatment. For each patient, hyperdense clot length was measured and recorded along with additional relevant imaging and clinical data.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results\u2014<\/jats:title>\n            <jats:p>\n              Mean age was 70 years, and mean time to computed tomography was 213 minutes. Median baseline National Institutes of Health Stroke Scale was 16.5. Occlusions were located in the internal carotid artery-terminus (34% [18 of 53]), middle cerebral artery M1 (49% [26 of 53]) and M2 segments (17% [9 of 53]). Hyperdense thrombus was visible in 96%, with mean and median clot lengths (mm) of 18.5 (\u00b114.2) and 16.1 (7.6\u201325.2), respectively. Occlusion location was the strongest predictor of clot length (multivariate,\n              <jats:italic>P<\/jats:italic>\n              =0.02). Clot length was \u22658 mm in 94%, 73%, and 22% of internal carotid artery-terminus, M1, and M2 occlusions, respectively.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>The majority of anterior circulation proximal occlusions are \u22658 mm long, helping to explain the low published rates of intravenous tissue-type plasminogen activator recanalization. Internal carotid artery-terminus occlusion is an excellent marker for clot length \u22658 mm; vessel-imaging status alone may be sufficient. Thin-section noncontrast computed tomography seems useful for patients with middle cerebral artery occlusion because of the wide variability of clot lengths.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/strokeaha.113.003079","type":"journal-article","created":{"date-parts":[[2013,10,9]],"date-time":"2013-10-09T01:53:38Z","timestamp":1381283618000},"page":"3553-3556","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":63,"title":["Clot Length Distribution and Predictors in Anterior Circulation Stroke"],"prefix":"10.1161","volume":"44","author":[{"given":"Shervin","family":"Kamalian","sequence":"first","affiliation":[{"name":"From the Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA (S.K., L.T.M., S.R.P., J.A.H., M.H.L., A.J.Y.); and Penumbra, Inc, Alameda, CA (M.A., S.P.S., A.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Livia T.","family":"Morais","sequence":"additional","affiliation":[{"name":"From the Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA (S.K., L.T.M., S.R.P., J.A.H., M.H.L., A.J.Y.); and Penumbra, Inc, Alameda, CA (M.A., S.P.S., A.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stuart R.","family":"Pomerantz","sequence":"additional","affiliation":[{"name":"From the Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA (S.K., L.T.M., S.R.P., J.A.H., M.H.L., A.J.Y.); and Penumbra, Inc, Alameda, CA (M.A., S.P.S., A.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Aceves","sequence":"additional","affiliation":[{"name":"From the Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA (S.K., L.T.M., S.R.P., J.A.H., M.H.L., A.J.Y.); and Penumbra, Inc, Alameda, CA (M.A., S.P.S., A.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siu Po","family":"Sit","sequence":"additional","affiliation":[{"name":"From the Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA (S.K., L.T.M., S.R.P., J.A.H., M.H.L., A.J.Y.); and Penumbra, Inc, Alameda, CA (M.A., S.P.S., A.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arani","family":"Bose","sequence":"additional","affiliation":[{"name":"From the Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA (S.K., L.T.M., S.R.P., J.A.H., M.H.L., A.J.Y.); and Penumbra, Inc, Alameda, CA (M.A., S.P.S., A.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua A.","family":"Hirsch","sequence":"additional","affiliation":[{"name":"From the Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA (S.K., L.T.M., S.R.P., J.A.H., M.H.L., A.J.Y.); and Penumbra, Inc, Alameda, CA (M.A., S.P.S., A.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael H.","family":"Lev","sequence":"additional","affiliation":[{"name":"From the Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA (S.K., L.T.M., S.R.P., J.A.H., M.H.L., A.J.Y.); and Penumbra, Inc, Alameda, CA (M.A., S.P.S., A.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albert J.","family":"Yoo","sequence":"additional","affiliation":[{"name":"From the Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA (S.K., L.T.M., S.R.P., J.A.H., M.H.L., A.J.Y.); and Penumbra, Inc, Alameda, CA (M.A., S.P.S., A.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1214300"},{"key":"e_1_3_4_3_2","unstructured":"Demchuk AM IMS III Investigators. IMS III: Comparison of outcomes between IV and IV\/IA treatment in baseline CTA confirmed ICA M1 M2 and basilar occlusions. International Stroke Conference; February 6\u20138 2013; Honolulu Hawaii United States. Session: IMS III: Results and Perspective. http:\/\/conference-cast.com\/AHA\/common\/presentations.aspx\/9\/32\/1304. Accessed July 10 2013."},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/strokeaha.110.580662"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/strokeaha.110.609693"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/strokeaha.112.649921"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/strokeaha.110.592535"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1136\/neurintsurg-2012-010565"},{"key":"e_1_3_4_9_2","unstructured":"Khatri P IMS III Investigators. Time to angiographic reperfusion is highly associated with good clinical outcome in the IMS III trial. International Stroke Conference Honolulu Hawaii United States February 6\u20138 2013. Abstract LB9."}],"container-title":["Stroke"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/STROKEAHA.113.003079","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T14:34:31Z","timestamp":1715610871000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/STROKEAHA.113.003079"}},"subtitle":["Implications for Intra-Arterial Therapy"],"short-title":[],"issued":{"date-parts":[[2013,12]]},"references-count":8,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2013,12]]}},"alternative-id":["10.1161\/STROKEAHA.113.003079"],"URL":"https:\/\/doi.org\/10.1161\/strokeaha.113.003079","relation":{},"ISSN":["0039-2499","1524-4628"],"issn-type":[{"value":"0039-2499","type":"print"},{"value":"1524-4628","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,12]]},"assertion":[{"value":"2013-08-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2013-09-04","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2013-10-08","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}