{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T18:28:01Z","timestamp":1792088881211,"version":"4.4.0"},"reference-count":33,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Intracranial atherosclerosis (ICAS) is associated with an increased risk of early recurrent ischemic stroke. We evaluated whether biomarkers of impaired distal perfusion\u2014specifically, anterior circulation borderzone infarct, and hypoperfusion mismatch volume\u2014were associated with recurrent ischemic stroke within 90 days.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>\n                      The BIORISK ICAS (Biomarkers and Recurrence Risk in Symptomatic Intracranial Atherosclerosis) is a multicenter retrospective international study (35 sites) that included hospitalized patients with symptomatic ICAS (50%\u201399% luminal stenosis of the intracranial vertebral, basilar, distal internal carotid, or proximal middle cerebral artery) from January 2019 to June 2024. The primary outcome was recurrent ischemic stroke in the territory of the symptomatic artery within 90 days. In the primary analysis, the exposure was an acute anterior circulation borderzone infarct. In secondary analysis of the subset with presentation within 72 hours of last known normal and perfusion imaging completed, the exposure of interest was prespecified as hypoperfusion mismatch volume at T\n                      <jats:sub>max<\/jats:sub>\n                      (time to maximum) threshold of 6 seconds, dichotomized at the Youden index. We performed multivariable Cox regression to test associations between exposure variables and the outcome, adjusting for clinically relevant variables and those associated with the outcome (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.1).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>Of 2050 patients with symptomatic ICAS, 1737 (84.7%) presented within 72 hours of symptom onset, among whom 509 (29.3%) underwent perfusion imaging. The primary analysis included 1891 patients; 174 (9.2%) patients had recurrent ischemic stroke in the symptomatic arterial territory. In adjusted Cox regression models, there was an association between anterior circulation borderzone infarct and recurrent ischemic stroke at 90 days (adjusted hazard ratio, 1.40 [95% CI, 1.02\u20131.93]). In the perfusion imaging analysis, hypoperfusion mismatch of \u226510 mL was associated with recurrent ischemic stroke (adjusted hazard ratio, 1.83 [95% CI, 1.03\u20133.28]).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>Biomarkers of impaired distal perfusion, anterior circulation borderzone infarct, and hypoperfusion mismatch were associated with increased risk of recurrent ischemic stroke. These findings support the use of perfusion imaging in ICAS as well as future trials investigating early reperfusion in high-risk patients with ICAS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/strokeaha.125.053160","type":"journal-article","created":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T14:30:06Z","timestamp":1761229806000},"page":"96-106","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["Impaired Perfusion and Early Ischemic Stroke Recurrence in Symptomatic Intracranial Atherosclerosis: BIORISK ICAS Study"],"prefix":"10.1161","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0031-1004","authenticated-orcid":true,"given":"Shadi","family":"Yaghi","sequence":"first","affiliation":[{"name":"Department of Neurology, The Warren Alpert Medical School of Brown University, Providence, RI (S.Y., F.K., S.L., A.S., L.S., K.F.)."},{"name":"Department of Neurology, Jersey Shore University Medical Center, Neptune, NJ (S.Y.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5958-6881","authenticated-orcid":true,"given":"Farhan","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Neurology, The Warren Alpert Medical School of Brown University, Providence, RI (S.Y., F.K., S.L., A.S., L.S., K.F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Skylar","family":"Lewis","sequence":"additional","affiliation":[{"name":"Department of Neurology, The Warren Alpert Medical School of Brown University, Providence, RI (S.Y., F.K., S.L., A.S., L.S., K.F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ava","family":"Stipanovich","sequence":"additional","affiliation":[{"name":"Department of Neurology, The Warren Alpert Medical School of Brown University, Providence, RI (S.Y., F.K., S.L., A.S., L.S., K.F.)."},{"name":"Department of Neurology, Thomas Jefferson University, Philadelphia, PA (S.A., M. Mayer)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1915-8775","authenticated-orcid":true,"given":"Richard","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Neurology, Medstar Health, Washington, District of Columbia (R.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Baker","sequence":"additional","affiliation":[{"name":"Department of Neurology, Christiana Care, Newark, DE (R.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8909-9761","authenticated-orcid":true,"given":"Sami","family":"Al Kasab","sequence":"additional","affiliation":[{"name":"Department of Neurology, Medical University of South Carolina, Charleston (S.A.K., A.A.Q.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmad","family":"Abu Qdais","sequence":"additional","affiliation":[{"name":"Department of Neurology, Medical University of South Carolina, Charleston (S.A.K., A.A.Q.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sridhara S.","family":"Yaddanapudi","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Maryland, Baltimore (S.S.Y., S. Sultana)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabiha","family":"Sultana","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Maryland, Baltimore (S.S.Y., S. Sultana)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6329-8703","authenticated-orcid":true,"given":"Muhib","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Neurology, Mayo Clinic, Rochester, MN (M. Khan, M. Malik)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0315-7631","authenticated-orcid":true,"given":"Maarij","family":"Malik","sequence":"additional","affiliation":[{"name":"Department of Neurology, Mayo Clinic, Rochester, MN (M. Khan, M. Malik)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1563-528X","authenticated-orcid":true,"given":"James","family":"Klaas","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Alabama at Birmingham (J.K., E.B., M.A.U.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7534-7218","authenticated-orcid":true,"given":"Ekaterina","family":"Bakradze","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Alabama at Birmingham (J.K., E.B., M.A.U.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9017-8659","authenticated-orcid":true,"given":"Muhammad","family":"Aemaz Ur Rehman","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Alabama at Birmingham (J.K., E.B., M.A.U.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5997-5342","authenticated-orcid":true,"given":"Christopher","family":"Leon Guerrero","sequence":"additional","affiliation":[{"name":"Department of Neurology, Atrium Health, Charlotte, NC (C.L.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7027-1901","authenticated-orcid":true,"given":"Hadley Walsh","family":"Ressler","sequence":"additional","affiliation":[{"name":"Wake Forest University School of Medicine, NC (H.W.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2626-6259","authenticated-orcid":true,"given":"Faddi G.","family":"Saleh Velez","sequence":"additional","affiliation":[{"name":"Brain Stimulation and Neurorehabilitation Laboratory, Department of Neurology, University of Oklahoma, Oklahoma City (F.G.S.V., C.O., C.B.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5020-2810","authenticated-orcid":true,"given":"Cameron","family":"Owens","sequence":"additional","affiliation":[{"name":"Brain Stimulation and Neurorehabilitation Laboratory, Department of Neurology, University of Oklahoma, Oklahoma City (F.G.S.V., C.O., C.B.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camila Bonin","family":"Pinto","sequence":"additional","affiliation":[{"name":"Brain Stimulation and Neurorehabilitation Laboratory, Department of Neurology, University of Oklahoma, Oklahoma City (F.G.S.V., C.O., C.B.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3770-8689","authenticated-orcid":true,"given":"Margy","family":"McCullough-Hicks","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Minnesota Twin Cities, Minneapolis (M.M.-H., D.C., A.P.P., P. Hariharan)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2508-0636","authenticated-orcid":true,"given":"Dawson","family":"Cooper","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Minnesota Twin Cities, Minneapolis (M.M.-H., D.C., A.P.P., P. Hariharan)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-0381-3541","authenticated-orcid":true,"given":"Abhiram","family":"Parameswaran Pillai","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Minnesota Twin Cities, Minneapolis (M.M.-H., D.C., A.P.P., P. Hariharan)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0115-3354","authenticated-orcid":true,"given":"Praveen","family":"Hariharan","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Minnesota Twin Cities, Minneapolis (M.M.-H., D.C., A.P.P., P. Hariharan)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaista","family":"Alam","sequence":"additional","affiliation":[{"name":"Department of Neurology, Thomas Jefferson University, Philadelphia, PA (S.A., M. Mayer)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morgan","family":"Mayer","sequence":"additional","affiliation":[{"name":"Department of Neurology, Thomas Jefferson University, Philadelphia, PA (S.A., M. Mayer)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3594-2159","authenticated-orcid":true,"given":"Mirjam R.","family":"Heldner","sequence":"additional","affiliation":[{"name":"Department of Neurology, Inselspital, Bern University Hospital (M.R.H., I.K., K.A.), University of Bern, Switzerland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irina","family":"Kugler","sequence":"additional","affiliation":[{"name":"Department of Neurology, Inselspital, Bern University Hospital (M.R.H., I.K., K.A.), University of Bern, Switzerland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1936-5451","authenticated-orcid":true,"given":"Kateryna","family":"Antonenko","sequence":"additional","affiliation":[{"name":"Department of Neurology, Inselspital, Bern University Hospital (M.R.H., I.K., K.A.), University of Bern, Switzerland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4217-4071","authenticated-orcid":true,"given":"William","family":"Almiri","sequence":"additional","affiliation":[{"name":"Institute of Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital (W.A.), University of Bern, Switzerland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8452-712X","authenticated-orcid":true,"given":"Sheila","family":"Martins","sequence":"additional","affiliation":[{"name":"Department of Neurology, Hospital de Cl\u00ednicas de Porto Alegre, Brazil (S.M., G.M.)."},{"name":"Department of Neurology, Hospital Moinhos de Vento, Porto Alegre, Brazil (S.M., T.L.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thais L.","family":"Secchi","sequence":"additional","affiliation":[{"name":"Department of Neurology, Hospital Moinhos de Vento, Porto Alegre, Brazil (S.M., T.L.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3187-0220","authenticated-orcid":true,"given":"Gabriel","family":"Mantovani","sequence":"additional","affiliation":[{"name":"Department of Neurology, Hospital de Cl\u00ednicas de Porto Alegre, Brazil (S.M., G.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8480-8220","authenticated-orcid":true,"given":"Aaron","family":"Rothstein","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Pennsylvania, Philadelphia (A.R., K.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9680-9565","authenticated-orcid":true,"given":"Kelly","family":"Sloane","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Pennsylvania, Philadelphia (A.R., K.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5825-1799","authenticated-orcid":true,"given":"Balaji","family":"Krishnaiah","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Tennessee at Memphis (B.K., L.A., C.E.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"Alfred","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Tennessee at Memphis (B.K., L.A., C.E.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9473-8051","authenticated-orcid":true,"given":"Cheran","family":"Elangovan","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Tennessee at Memphis (B.K., L.A., C.E.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3654-8137","authenticated-orcid":true,"given":"Venugopalan Y.","family":"Vishnu","sequence":"additional","affiliation":[{"name":"Department of Neurology, All India Institute of Medical Sciences, New Delhi (V.Y.V., M. Chandu, A.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-1208-3325","authenticated-orcid":true,"given":"Meena","family":"Chandu","sequence":"additional","affiliation":[{"name":"Department of Neurology, All India Institute of Medical Sciences, New Delhi (V.Y.V., M. Chandu, A.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2303-1961","authenticated-orcid":true,"given":"Ayush","family":"Agarwal","sequence":"additional","affiliation":[{"name":"Department of Neurology, All India Institute of Medical Sciences, New Delhi (V.Y.V., M. Chandu, A.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8009-8543","authenticated-orcid":true,"given":"Michele","family":"Romoli","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Neurology and Stroke Unit, Bufalini Hospital, Cesena, Italy (M. Romoli, N.M., S. Vozzi)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Marrone","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Neurology and Stroke Unit, Bufalini Hospital, Cesena, Italy (M. Romoli, N.M., S. Vozzi)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Vozzi","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Neurology and Stroke Unit, Bufalini Hospital, Cesena, Italy (M. Romoli, N.M., S. Vozzi)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2350-284X","authenticated-orcid":true,"given":"Malik","family":"Ghannam","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Iowa, Iowa City (M.G., M.E., M.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0106-3647","authenticated-orcid":true,"given":"Mohamed","family":"Elshikh","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Iowa, Iowa City (M.G., M.E., M.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1690-1084","authenticated-orcid":true,"given":"Mahmoud","family":"Dibas","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Iowa, Iowa City (M.G., M.E., M.D.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3901-9916","authenticated-orcid":true,"given":"Yan","family":"Hou","sequence":"additional","affiliation":[{"name":"Department of Neurology, Hartford Hospital, CT (Y.H., K.P., A. Tunguturi)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krithika","family":"Peshwe","sequence":"additional","affiliation":[{"name":"Department of Neurology, Hartford Hospital, CT (Y.H., K.P., A. Tunguturi)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4257-3670","authenticated-orcid":true,"given":"Ajay","family":"Tunguturi","sequence":"additional","affiliation":[{"name":"Department of Neurology, Hartford Hospital, CT (Y.H., K.P., A. Tunguturi)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2277-5950","authenticated-orcid":true,"given":"Jo\u00e3o Pedro","family":"Marto","sequence":"additional","affiliation":[{"name":"Department of Neurology (J.P.M.), Hospital de Egas Moniz, ULS Lisboa Ocidental, Portugal."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0001-742X","authenticated-orcid":true,"given":"Rui","family":"Duarte Armindo","sequence":"additional","affiliation":[{"name":"Department of Neuroradiology (R.D.A.), Hospital de Egas Moniz, ULS Lisboa Ocidental, Portugal."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0719-2522","authenticated-orcid":true,"given":"Jennifer","family":"Frontera","sequence":"additional","affiliation":[{"name":"Department of Neurology, New York University, NY (J.F., L.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9500-6162","authenticated-orcid":true,"given":"Lindsey","family":"Kuohn","sequence":"additional","affiliation":[{"name":"Department of Neurology, New York University, NY (J.F., L.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5051-6687","authenticated-orcid":true,"given":"Mohammad","family":"AlMajali","sequence":"additional","affiliation":[{"name":"Department of Neurology, Mercy Health\u2013Saint Vincent Medical Center, Toledo, OH (M.A., O.O.Z., B.B., N.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4881-4698","authenticated-orcid":true,"given":"Osama O.","family":"Zaidat","sequence":"additional","affiliation":[{"name":"Department of Neurology, Mercy Health\u2013Saint Vincent Medical Center, Toledo, OH (M.A., O.O.Z., B.B., N.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6511-3848","authenticated-orcid":true,"given":"Benan","family":"Barakat","sequence":"additional","affiliation":[{"name":"Department of Neurology, Mercy Health\u2013Saint Vincent Medical Center, Toledo, OH (M.A., O.O.Z., B.B., N.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niha","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Neurology, Mercy Health\u2013Saint Vincent Medical Center, Toledo, OH (M.A., O.O.Z., B.B., N.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7529-4267","authenticated-orcid":true,"given":"Alexis N.","family":"Simpkins","sequence":"additional","affiliation":[{"name":"Department of Neurology, Cedars-Sinai Medical Center, Los Angeles, CA (A.N.S., S. Sen)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shayak","family":"Sen","sequence":"additional","affiliation":[{"name":"Department of Neurology, Cedars-Sinai Medical Center, Los Angeles, CA (A.N.S., S. Sen)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-3487-027X","authenticated-orcid":true,"given":"Mariana","family":"Coelho","sequence":"additional","affiliation":[{"name":"Department of Neurology, Coimbra University, Portugal (M. Coelho, J.S.F., J.A.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4665-5697","authenticated-orcid":true,"given":"Joao","family":"Sargento Fritas","sequence":"additional","affiliation":[{"name":"Department of Neurology, Coimbra University, Portugal (M. Coelho, J.S.F., J.A.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5199-6210","authenticated-orcid":true,"given":"Joao Andre","family":"Sousa","sequence":"additional","affiliation":[{"name":"Department of Neurology, Coimbra University, Portugal (M. Coelho, J.S.F., J.A.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6702-7924","authenticated-orcid":true,"given":"Diana","family":"Aguiar de Sousa","sequence":"additional","affiliation":[{"name":"Stroke Center, Centro Hospitalar Universit\u00e1rio Lisboa Central, and Institute of Anatomy, Faculdade de Medicina da Universidade de Lisboa, Portugal (D.A.d.S., M.S., A.C.L.F.R.)."},{"name":"Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal (D.A.d.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7508-0645","authenticated-orcid":true,"given":"Mafalda","family":"Soares","sequence":"additional","affiliation":[{"name":"Stroke Center, Centro Hospitalar Universit\u00e1rio Lisboa Central, and Institute of Anatomy, Faculdade de Medicina da Universidade de Lisboa, Portugal (D.A.d.S., M.S., A.C.L.F.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1020-0060","authenticated-orcid":true,"given":"Amanda","family":"Cyntia Lima Fonseca Rodrigues","sequence":"additional","affiliation":[{"name":"Stroke Center, Centro Hospitalar Universit\u00e1rio Lisboa Central, and Institute of Anatomy, Faculdade de Medicina da Universidade de Lisboa, Portugal (D.A.d.S., M.S., A.C.L.F.R.)."},{"name":"Department of Neurology, University of North Carolina at Chapel Hill (A.C.L.F.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-1305-0819","authenticated-orcid":true,"given":"Aditya","family":"Jhaveri","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Chicago, IL (A.J., R.Z.M., J.S., S.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2131-3711","authenticated-orcid":true,"given":"Rami Z.","family":"Morsi","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Chicago, IL (A.J., R.Z.M., J.S., S.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0287-3967","authenticated-orcid":true,"given":"James","family":"Siegler","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Chicago, IL (A.J., R.Z.M., J.S., S.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3515-4005","authenticated-orcid":true,"given":"Yasmin N.","family":"Aziz","sequence":"additional","affiliation":[{"name":"Department of Neurology and Rehabilitation Medicine, University of Cincinnati, OH (Y.N.A., P. Harker, S.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0263-8748","authenticated-orcid":true,"given":"Pablo","family":"Harker","sequence":"additional","affiliation":[{"name":"Department of Neurology and Rehabilitation Medicine, University of Cincinnati, OH (Y.N.A., P. Harker, S.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonia","family":"Bhati","sequence":"additional","affiliation":[{"name":"Department of Neurology and Rehabilitation Medicine, University of Cincinnati, OH (Y.N.A., P. Harker, S.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1540-8650","authenticated-orcid":true,"given":"Sophia","family":"Vassilopoulou","sequence":"additional","affiliation":[{"name":"1st Department of Neurology, National and Kapodistrian University of Athens, Greece (S. Vassilopoulou, A. Tountopoulou)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3276-588X","authenticated-orcid":true,"given":"Argyro","family":"Tountopoulou","sequence":"additional","affiliation":[{"name":"1st Department of Neurology, National and Kapodistrian University of Athens, Greece (S. Vassilopoulou, A. Tountopoulou)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8178-8597","authenticated-orcid":true,"given":"Adam","family":"de Havenon","sequence":"additional","affiliation":[{"name":"Department of Neurology, Yale University, New Haven, CT (A.d.H., P. Khatri)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Varsha","family":"Muddasani","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Texas, Houston (V.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3883-5623","authenticated-orcid":true,"given":"Nils","family":"Henninger","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Massachusetts Chan Medical School, Worcester (N.H., H.T., J.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8449-3719","authenticated-orcid":true,"given":"Hieu","family":"Tran","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Massachusetts Chan Medical School, Worcester (N.H., H.T., J.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johanna","family":"Helenius","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Massachusetts Chan Medical School, Worcester (N.H., H.T., J.H.)."},{"name":"Department of Neurology, Lahey Hospital and Medical Center, Burlington, MA (J.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9944-2495","authenticated-orcid":true,"given":"Mohammad","family":"Khasawneh","sequence":"additional","affiliation":[{"name":"Department of Neurology (M. Khasawneh), Washington University in St. Louis, MO."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2056-6610","authenticated-orcid":true,"given":"Ananth","family":"Vellimana","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery (A.V., D.S.L.), Washington University in St. Louis, MO."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4992-6704","authenticated-orcid":true,"given":"Ryan","family":"Apfel","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of California, Los Angeles (R.A., A.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7184-8613","authenticated-orcid":true,"given":"Amir","family":"Molaie","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of California, Los Angeles (R.A., A.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7683-7235","authenticated-orcid":true,"given":"Marina","family":"Mannino","sequence":"additional","affiliation":[{"name":"Department of Neurology and Stroke Unit, Azienda Ospedaliera Ospedali Riuniti (AOOR) Villa Sofia-V. Cervello, Palermo, Italy (M. Mannino, V.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-3409-1040","authenticated-orcid":true,"given":"Valeria","family":"Terruso","sequence":"additional","affiliation":[{"name":"Department of Neurology and Stroke Unit, Azienda Ospedaliera Ospedali Riuniti (AOOR) Villa Sofia-V. Cervello, Palermo, Italy (M. Mannino, V.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tarek","family":"El Halabi","sequence":"additional","affiliation":[{"name":"Department of Neurology (T.E.H., M. Reda), American University of Beirut Medical Center, Lebanon."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahasen","family":"Reda","sequence":"additional","affiliation":[{"name":"Department of Neurology (T.E.H., M. Reda), American University of Beirut Medical Center, Lebanon."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christel","family":"Tamer","sequence":"additional","affiliation":[{"name":"Department of Radiology (C.T.), American University of Beirut Medical Center, Lebanon."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7468-137X","authenticated-orcid":true,"given":"Piers","family":"Klein","sequence":"additional","affiliation":[{"name":"Department of Neurology, Boston University, MA (P. Klein, T.N.N.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9784-8475","authenticated-orcid":true,"given":"Liqi","family":"Shu","sequence":"additional","affiliation":[{"name":"Department of Neurology, The Warren Alpert Medical School of Brown University, Providence, RI (S.Y., F.K., S.L., A.S., L.S., K.F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7344-8266","authenticated-orcid":true,"given":"Pooja","family":"Khatri","sequence":"additional","affiliation":[{"name":"Department of Neurology, Yale University, New Haven, CT (A.d.H., P. Khatri)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0065-3784","authenticated-orcid":true,"given":"Karen","family":"Furie","sequence":"additional","affiliation":[{"name":"Department of Neurology, The Warren Alpert Medical School of Brown University, Providence, RI (S.Y., F.K., S.L., A.S., L.S., K.F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2810-1685","authenticated-orcid":true,"given":"Thanh N.","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Department of Neurology, Boston University, MA (P. Klein, T.N.N.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5109-8736","authenticated-orcid":true,"given":"David S.","family":"Liebeskind","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery (A.V., D.S.L.), Washington University in St. Louis, MO."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0724-1694","authenticated-orcid":true,"given":"Shyam","family":"Prabhakaran","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Chicago, IL (A.J., R.Z.M., J.S., S.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.116.308441"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1747-4949.2006.00045.x"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1212\/wnl.45.4.659"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)62038-3"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1105335"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2015.1693"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(13)70195-9"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.119.028528"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.118.024147"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.118.021007"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.117.019173"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2015.3772"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1161\/strokeaha.118.020840"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.125.051352"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.123.044386"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)61602-X"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1148\/rg.315105014"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.59.1.87"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/116.1.161"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1161\/STR.0b013e318296aeca"},{"key":"e_1_3_3_22_2","first-page":"643","article-title":"A standardized method for measuring intracranial arterial stenosis.","volume":"21","author":"Samuels OB","year":"2000","unstructured":"Samuels OB, Joseph GJ, Lynn MJ, Smith HA, Chimowitz MI. A standardized method for measuring intracranial arterial stenosis. AJNR Am J Neuroradiol. 2000;21:643\u2013646.","journal-title":"AJNR Am J Neuroradiol"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.52.suppl_1.P605"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.51.suppl_1.wmp45"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1111\/jon.12630"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.116.016254"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1111\/jon.12710"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2022.12000"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.118.023996"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1136\/svn-2021-000979"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2024.12829"},{"key":"e_1_3_3_32_2","doi-asserted-by":"publisher","DOI":"10.1161\/STR.0000000000000375"},{"key":"e_1_3_3_33_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000200030"},{"key":"e_1_3_3_34_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0165341"}],"container-title":["Stroke"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/STROKEAHA.125.053160","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T16:07:09Z","timestamp":1768406829000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/STROKEAHA.125.053160"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":33,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1161\/STROKEAHA.125.053160"],"URL":"https:\/\/doi.org\/10.1161\/strokeaha.125.053160","relation":{},"ISSN":["0039-2499","1524-4628"],"issn-type":[{"value":"0039-2499","type":"print"},{"value":"1524-4628","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2025-07-29","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-30","order":1,"name":"revised","label":"Revised","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-06","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-23","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}