{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T11:54:45Z","timestamp":1767182085319,"version":"3.41.2"},"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\">Delays in endovascular reperfusion for patients with large vessel occlusion stroke are known to worsen outcomes, and the mechanism is believed to be time\u2010dependent expansion of the ischemic infarction. In this study, we hypothesize that delays in onset to reperfusion (OTR) assert an effect on outcomes independent of effects of final infarct (FI).<\/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 subgroup analysis from the prospective multicenter COMPLETE (International Acute Ischemic Stroke Registry With the Penumbra System Aspiration Including the 3D Revascularization Device; Penumbra, Inc) registry for 257 patients with anterior circulation large vessel occlusion who underwent endovascular therapy with successful reperfusion (modified treatment in cerebral infarction score 2b\/3). FI was measured by Alberta Stroke Program Early CT score and volume on 24\u2010 to 48\u2010hour computed tomography or magnetic resonance imaging. The likelihood of 90\u2010day good functional outcome (modified Rankin scale 0\u20132) was assessed by OTR and absolute risk difference (ARD) was estimated using multivariable logistic regressions adjusting for patient characteristics including FI.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Results<\/jats:title>\n            <jats:p xml:lang=\"en\">In univariable analysis, longer OTR was associated with a decreased likelihood of good functional outcome (ARD \u20133% [95% CI \u20134.5 to \u20131.0]\/h delay). In multivariable analysis accounting for FI, the association between OTR and functional outcome remained significant (ARD \u20132% [95% CI \u20133.5 to \u20130.4]\/h delay) with similar ARD. This finding was maintained in the subset of patients with FI imaging using CT only, using Alberta Stroke Program Early CT Score or volumetric FI measurements, and also in patients with larger versus smaller FIs.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">The impact of OTR on outcomes appears to be mostly through a mechanism that is independent of FI. Our findings suggest that although the field has moved toward imaging infarct core definitions of eligibility for endovascular treatment, time remains an important predictor of outcome, independent of infarct core.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/svin.121.000163","type":"journal-article","created":{"date-parts":[[2022,5,20]],"date-time":"2022-05-20T14:18:27Z","timestamp":1653056307000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Duration of Ischemia Affects Outcomes Independent of Infarct Size in Stroke"],"prefix":"10.1161","volume":"2","author":[{"given":"Youngran","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Neurology UTHealth McGovern Medical School Houston TX"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Swapnil","family":"Khose","sequence":"additional","affiliation":[{"name":"Department of Neurology UTHealth McGovern Medical School Houston TX"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Osama O.","family":"Zaidat","sequence":"additional","affiliation":[{"name":"Neuroscience Institute Mercy Health St. Vincent Medical Center Toledo OH"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ameer E.","family":"Hassan","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Texas Rio Grande Valley Harlingen TX"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johanna T.","family":"Fifi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Icahn School of Medicine at Mount Sinai New York NY"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashish","family":"Nanda","sequence":"additional","affiliation":[{"name":"University of Missouri Columbia MO"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin","family":"Atchie","sequence":"additional","affiliation":[{"name":"Department of Radiology Swedish Medical Center Englewood CO"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Britton","family":"Woodward","sequence":"additional","affiliation":[{"name":"Vista Radiology Knoxville TN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arnd","family":"Doerfler","sequence":"additional","affiliation":[{"name":"Department of Neuroradiology University of Erlangen\u2010Nuremberg Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alejandro","family":"Tomasello","sequence":"additional","affiliation":[{"name":"Department of Radiology Vall d'Hebron University Hospital Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Albert J.","family":"Yoo","sequence":"additional","affiliation":[{"name":"Texas Stroke Institute Dallas\u2010Fort Worth TX"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0602-8509","authenticated-orcid":false,"given":"Sunil A.","family":"Sheth","sequence":"additional","affiliation":[{"name":"Department of Neurology UTHealth McGovern Medical School Houston TX"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1411587"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(16)30177-6"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1414792"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1503780"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1415061"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1706442"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.13647"},{"key":"e_1_3_2_9_2","first-page":"1789","article-title":"Angiographic assessment of pial collaterals as a prognostic indicator following intra\u2010arterial thrombolysis for acute ischemic stroke","volume":"26","author":"Christoforidis GA","year":"2005","unstructured":"Christoforidis GA, Mohammad Y, Kehagias D, Avutu B, Slivka AP. 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