{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T21:03:05Z","timestamp":1790283785195,"version":"4.1.0"},"reference-count":12,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","license":[{"start":{"date-parts":[[2023,6,1]],"date-time":"2023-06-01T00:00:00Z","timestamp":1685577600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>Infarct in a new territory (INT) is a known complication of endovascular stroke therapy. We assessed the incidence of INT, outcomes after INT, and the impact of concurrent treatments with intravenous thrombolysis and nerinetide.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>Data are from ESCAPE-NA1 trial (Safety and Efficacy of Nerinetide [NA-1] in Subjects Undergoing Endovascular Thrombectomy for Stroke), a multicenter, international randomized study that assessed the efficacy of intravenous nerinetide in subjects with acute ischemic stroke who underwent endovascular thrombectomy within 12 hours from onset. Concurrent treatment and outcomes were collected as part of the trial protocol. INTs were identified on core lab imaging review of follow-up brain imaging and defined by the presence of infarct in a new vascular territory, outside the baseline target occlusion(s) on follow-up brain imaging (computed tomography or magnetic resonance imaging). INTs were classified by maximum diameter (&lt;2, 2\u201320, and &gt;20 mm), number, and location. The association between INT and clinical outcomes (modified Rankin Scale and death) was assessed using standard descriptive techniques and adjusted estimates of effect were derived from Poisson regression models.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>Among 1092 patients, 103 had INT (9.3%, median age 69.5 years, 49.5% females). There were no differences in baseline characteristics between those with versus without INT. Most INTs (91\/103, 88.3%) were not associated with visible occlusions on angiography and 39 out of 103 (37.8%) were &gt;20 mm in maximal diameter. The most common INT territory was the anterior cerebral artery (27.8%). Almost half of the INTs were multiple (46 subjects, 43.5%, range, 2\u201312). INT was associated with poorer outcomes as compared to no INT on the primary outcome of modified Rankin Scale score of 0 to 2 at 90 days (adjusted risk ratio, 0.71 [95% CI, 0.57\u20130.89]). Infarct volume in those with INT was greater by a median of 21 cc compared with those without, and there was a greater risk of death as compared to patients with no INT (adjusted risk ratio, 2.15 [95% CI, 1.48\u20133.13]).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>Infarcts in a new territory are common in individuals undergoing endovascular thrombectomy for acute ischemic stroke and are associated with poorer outcomes. Optimal therapeutic approaches, including technical strategies, to reduce INT represent a new target for incremental quality improvement of endovascular thrombectomy.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Registration:<\/jats:title>\n            <jats:p>\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              ; Unique identifier: NCT02930018.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/strokeaha.122.042200","type":"journal-article","created":{"date-parts":[[2023,4,21]],"date-time":"2023-04-21T09:04:20Z","timestamp":1682067860000},"page":"1477-1483","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":16,"title":["Infarcts in a New Territory: Insights From the ESCAPE-NA1 Trial"],"prefix":"10.1161","volume":"54","clinical-trial-number":[{"clinical-trial-number":"nct02930018","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3647-0904","authenticated-orcid":true,"given":"Nishita","family":"Singh","sequence":"first","affiliation":[{"name":"Department of Clinical Neurosciences (N.S., M.M., A.M.D., M.A.A., M.D.H.), Cumming School of Medicine, University of Calgary and Foothills Medical Centre, Calgary, AB, Canada."},{"name":"Department of Internal Medicine, Health Sciences Center, University of Manitoba, Winnipeg, Canada (N.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8058-383X","authenticated-orcid":true,"given":"Petra","family":"Cimflova","sequence":"additional","affiliation":[{"name":"Department of Radiology (P.C., J.M.O., N.K., A.M., M.G., M.A.A., M.D.H.), Cumming School of Medicine, University of Calgary and Foothills Medical Centre, Calgary, AB, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0029-6764","authenticated-orcid":true,"given":"Johanna Maria","family":"Ospel","sequence":"additional","affiliation":[{"name":"Department of Radiology (P.C., J.M.O., N.K., A.M., M.G., M.A.A., M.D.H.), Cumming School of Medicine, University of Calgary and Foothills Medical Centre, Calgary, AB, Canada."},{"name":"Division of Neuroradiology, Clinic of Radiology and Nuclear Medicine, University Hospital Basel, University of Basel, Switzerland (J.M.O.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9752-784X","authenticated-orcid":true,"given":"Nima","family":"Kashani","sequence":"additional","affiliation":[{"name":"Department of Radiology (P.C., J.M.O., N.K., A.M., M.G., M.A.A., M.D.H.), Cumming School of Medicine, University of Calgary and Foothills Medical Centre, Calgary, AB, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9063-0465","authenticated-orcid":true,"given":"Martha","family":"Marko","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurosciences (N.S., M.M., A.M.D., M.A.A., M.D.H.), Cumming School of Medicine, University of Calgary and Foothills Medical Centre, Calgary, AB, Canada."},{"name":"Department of Neurology, Medical University of Vienna, Austria (M.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arnuv","family":"Mayank","sequence":"additional","affiliation":[{"name":"Department of Radiology (P.C., J.M.O., N.K., A.M., M.G., M.A.A., M.D.H.), Cumming School of Medicine, University of Calgary and Foothills Medical Centre, Calgary, AB, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4532-153X","authenticated-orcid":true,"given":"Raul G.","family":"Nogueira","sequence":"additional","affiliation":[{"name":"Department of Neurology, Emory University School of Medicine, Atlanta (R.G.N.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5853-5161","authenticated-orcid":true,"given":"Ryan A.","family":"McTaggart","sequence":"additional","affiliation":[{"name":"Department of Interventional Radiology, Warren Alpert Medical School of Brown University, Providence (R.A.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4930-7789","authenticated-orcid":true,"given":"Andrew M.","family":"Demchuk","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurosciences (N.S., M.M., A.M.D., M.A.A., M.D.H.), Cumming School of Medicine, University of Calgary and Foothills Medical Centre, Calgary, AB, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1419-2635","authenticated-orcid":true,"given":"Alexandre Y.","family":"Poppe","sequence":"additional","affiliation":[{"name":"Centre Hospitalier de l\u2019Universit\u00e9 de Montr\u00e9al, Canada (A.Y.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2324-8415","authenticated-orcid":true,"given":"Jeremy L.","family":"Rempel","sequence":"additional","affiliation":[{"name":"Department of Radiology, University of Alberta Hospital, Edmonton, Canada (J.L.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1176-0633","authenticated-orcid":true,"given":"Thalia S.","family":"Field","sequence":"additional","affiliation":[{"name":"Vancouver Stroke Program, Division of Neurology, University of British Columbia, Vancouver, Canada (T.S.F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1379-3612","authenticated-orcid":true,"given":"Dar","family":"Dowlatshahi","sequence":"additional","affiliation":[{"name":"Department of Neurology, Ottawa Hospital, University of Ottawa, Canada (D.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2675-6116","authenticated-orcid":true,"given":"Brian","family":"van Adel","sequence":"additional","affiliation":[{"name":"Departments of Radiology and Neurosurgery, McMaster University, Hamilton, Canada (B.v.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6571-5531","authenticated-orcid":true,"given":"Richard H.","family":"Swartz","sequence":"additional","affiliation":[{"name":"Department of Neurology, Sunnybrook Health Sciences Centre (R.H.S.), University Health Network, University of Toronto, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruchir","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Neurology, Erlanger Hospital, Chattanooga (R.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4399-1142","authenticated-orcid":true,"given":"Eric","family":"Sauvageau","sequence":"additional","affiliation":[{"name":"Lyerly Neurosurgery, Baptist Hospital, Jacksonville (E.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1415-3027","authenticated-orcid":true,"given":"Volker","family":"Puetz","sequence":"additional","affiliation":[{"name":"Department of Neurology and Dresden Neurovascular Center, University Hospital Carl Gustav Carus at the Technical University Dresden, Germany (V.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7569-8429","authenticated-orcid":true,"given":"Frank L.","family":"Silver","sequence":"additional","affiliation":[{"name":"Department of Neurology (F.L.S.), University Health Network, University of Toronto, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3632-9433","authenticated-orcid":true,"given":"Bruce","family":"Campbell","sequence":"additional","affiliation":[{"name":"Department of Neurology, The Royal Melbourne Hospital, University of Melbourne, Parkville, Australia (B.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2584-8361","authenticated-orcid":true,"given":"Ren\u00e9","family":"Chapot","sequence":"additional","affiliation":[{"name":"Department of Neuroradiology, Alfred Krupp Krankenhaus Essen, Essen, Germany (R.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6311-9565","authenticated-orcid":true,"given":"Michael","family":"Tymianski","sequence":"additional","affiliation":[{"name":"NoNO Inc., Toronto, Canada (M.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9060-2109","authenticated-orcid":true,"given":"Mayank","family":"Goyal","sequence":"additional","affiliation":[{"name":"Department of Radiology (P.C., J.M.O., N.K., A.M., M.G., M.A.A., M.D.H.), Cumming School of Medicine, University of Calgary and Foothills Medical Centre, Calgary, AB, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9550-8197","authenticated-orcid":true,"given":"Mohammed A.","family":"Almekhlafi","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurosciences (N.S., M.M., A.M.D., M.A.A., M.D.H.), Cumming School of Medicine, University of Calgary and Foothills Medical Centre, Calgary, AB, Canada."},{"name":"Department of Radiology (P.C., J.M.O., N.K., A.M., M.G., M.A.A., M.D.H.), Cumming School of Medicine, University of Calgary and Foothills Medical Centre, Calgary, AB, Canada."},{"name":"Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, AB, Canada (M.A.A., M.D.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6269-1543","authenticated-orcid":true,"given":"Michael D.","family":"Hill","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurosciences (N.S., M.M., A.M.D., M.A.A., M.D.H.), Cumming School of Medicine, University of Calgary and Foothills Medical Centre, Calgary, AB, Canada."},{"name":"Department of Radiology (P.C., J.M.O., N.K., A.M., M.G., M.A.A., M.D.H.), Cumming School of Medicine, University of Calgary and Foothills Medical Centre, Calgary, AB, Canada."},{"name":"Department of Medicine (M.D.H.), Cumming School of Medicine, University of Calgary and Foothills Medical Centre, Calgary, AB, Canada."},{"name":"Department of Community Health Sciences (M.D.H.), Cumming School of Medicine, University of Calgary and Foothills Medical Centre, Calgary, AB, Canada."},{"name":"Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, AB, Canada (M.A.A., M.D.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"on behalf of the ESCAPE-NA1 Trial 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