{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T17:28:49Z","timestamp":1785173329431,"version":"3.55.0"},"reference-count":31,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["SVIN"],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Time to reperfusion is believed to influence clinical outcomes following thrombectomy mainly through reduction of infarct growth. In this study, we aim to understand whether clinical outcomes can be influenced by ischemia duration (penumbral time) independent of postintervention infarct volume by comparing outcomes following thrombectomy in patients with similar (and small) follow\u2010up infarct volumes.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods<\/jats:title>\n            <jats:p xml:lang=\"en\">We performed a retrospective analysis of a prospectively maintained large\u2010vessel occlusion stroke thrombectomy database across 3 US centers. Demographic, clinical, radiological, and outcomes data of patients with anterior circulation large\u2010vessel occlusion (internal carotid or middle cerebral artery M1) stroke who had a witnessed\u2010onset stroke, had substantial penumbral volumes, achieved successful reperfusion (modified thrombolysis in cerebral infarction 2b\u20103), and had a follow\u2010up infarct volume of &lt;20\u00a0mL were analyzed.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              A total of 233 patients (center A, 25; center B, 33; center C, 175) were included. Mean age was 71\u00b116 years, and median National Institutes of Health Stroke Scale was 15 (10\u201320). Median penumbral time was 4.7 (2.9\u201310) hours, and median follow\u2010up infarct volume was 4.7 (0.2\u20139.4)\u00a0mL. Despite comparable baseline characteristics and 24\u2010hour infarct volumes, patients reperfused in the 0\u2010 to 6\u2010hour time window had significantly higher rates of modified Rankin scale 0 to 2 (61% versus 40%;\n              <jats:italic>P<\/jats:italic>\n              =0.002) and numerically lower rates of mortality (11% versus 17%;\n              <jats:italic>P<\/jats:italic>\n              =0.16) at 90\u00a0days when compared with patients reperfused in the 6\u2010 to 24\u2010hour time window. Duration of ischemia is an independent predictor of modified Rankin scale 0 to 2 (odds ratio, 0.91 [0.80\u20130.99];\n              <jats:italic>P<\/jats:italic>\n              =0.012). In multivariable analysis accounting for age and baseline National Institutes of Health Stroke Scale score, the association between penumbral time and modified Rankin scale 0 to 2 remained significant (absolute risk difference, \u22121.2% [(95% CI, \u22121.9 to \u22120.4)]\/h delay).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p xml:lang=\"en\">Longer penumbral duration is associated with a lower likelihood of functional independence among large\u2010vessel occlusion strokes with small and comparable 24\u2010hour follow\u2010up infarct volume. Our findings indicate that delays in time to reperfusion affect clinical outcomes through mechanisms mediated by factors not solely limited to infarct reduction.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/svin.121.000153","type":"journal-article","created":{"date-parts":[[2022,5,9]],"date-time":"2022-05-09T05:55:38Z","timestamp":1652075738000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Duration of Ischemia Impacts Postreperfusion Clinical Outcomes Independent of Follow\u2010Up Infarct Volume"],"prefix":"10.1161","volume":"2","author":[{"given":"Shashvat M.","family":"Desai","sequence":"first","affiliation":[{"name":"HonorHealth Research Institute Scottsdale AZ"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amin","family":"Aghaebrahim","sequence":"additional","affiliation":[{"name":"Department of Neurology and Neurosurgery Baptist Health Jacksonville FL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James E.","family":"Siegler","sequence":"additional","affiliation":[{"name":"Cooper University Hospital Cooper Neurological Institute Cooper University Hospital Camden NJ"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andre","family":"Monteiro","sequence":"additional","affiliation":[{"name":"Department of Neurology and Neurosurgery Baptist Health Jacksonville FL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruchira M.","family":"Jha","sequence":"additional","affiliation":[{"name":"Department of Neurology Barrow Neurological Institute Phoenix AZ"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashutosh P.","family":"Jadhav","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Barrow Neurological Institute Phoenix AZ"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2619-6975","authenticated-orcid":false,"given":"Tudor G.","family":"Jovin","sequence":"additional","affiliation":[{"name":"Cooper University Hospital Cooper Neurological Institute Cooper University Hospital Camden NJ"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/STR.0000000000000211"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)00163-X"},{"key":"e_1_3_2_4_2","article-title":"Relationship between the degree of recanalization and functional outcome in acute ischemic stroke is mediated by penumbra salvage volume","author":"Broocks G","year":"2021","unstructured":"Broocks G, Jafarov H, McDonough R, Austein F, Meyer L, Bechstein M, van Horn N, Nawka MT, Sch\u00f6n G, Fiehler J, et\u00a0al. 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