{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T05:11:02Z","timestamp":1784956262543,"version":"3.55.0"},"reference-count":17,"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":[[2024,9]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Orbital infarction syndrome (OIS) is a rare entity defined as acute ischemia of intraorbital structures. Its occurrence requires interruption of the rich collateral supply to the orbit from both the ophthalmic artery (OA) and branches of the external carotid artery. Three case reports have recently been published of OIS occurring after endovascular thrombectomy (EVT). The goal of this study was to determine the true incidence of post\u2010EVT OIS and to identify associated imaging findings on computed tomography angiography and digital subtraction angiography (DSA).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods<\/jats:title>\n            <jats:p xml:lang=\"en\">A retrospective cohort study was performed at our comprehensive stroke center, including all patients who underwent EVT for anterior circulation strokes in 2019 and 2020. Patient charts were reviewed up to 24 hours after EVT for the presence of acute painful vision loss, ophthalmoplegia, chemosis, and proptosis. Patients with any combination of these symptoms in the absence of a carotid\u2010cavernous fistula were defined as having OIS. Pre\u2010EVT computed tomography angiography, pre\u2010EVT DSA, and post\u2010EVT DSA images were reviewed to determine the sensitivity and specificity of absent OA opacification, nonopacified external carotid artery, and absent choroid blush (CB) for post\u2010EVT OIS. Patients were excluded from sensitivity and specificity analysis for each finding that was objectively impossible to assess on their images, either because it was outside the field of view or not tested during the procedure. Findings were deemed indeterminate if motion artifact or contrast timing led to uncertainty about their presence. Sensitivity and specificity calculations were performed on a worst\u2010case\u2010scenario basis, with all indeterminate findings assumed to be false positives or false negatives.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Results<\/jats:title>\n            <jats:p xml:lang=\"en\">Of 217 patients with anterior circulation EVT (male:female, 107:110; median age, 73 [21\u201398] years), 4 cases of OIS were discovered (male:female, 1:3; median age, 71 [66\u201380] years; incidence, 1.7%). The number of patients excluded from sensitivity and specificity analysis for each imaging finding was as follows: 34 for pre\u2010EVT CB, 45 for post\u2010EVT CB, 7 for pre\u2010EVT OA, and 19 for post\u2010EVT OA. CB was deemed indeterminate in 47 patients on pre\u2010EVT DSA and 36 patients on post\u2010EVT DSA. All indeterminate cases occurred in non\u2010OIS patients and were counted as false negatives. Absent OA opacification was 50% sensitive and 91% specific for OIS on both pre\u2010EVT computed tomography angiography and pre\u2010EVT DSA, and 0% sensitive and 97% specific on post\u2010EVT DSA. Absent CB was 33% sensitive and 65% specific for OIS on pre\u2010EVT DSA, and 100% sensitive and 73% specific on post\u2010EVT DSA.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p xml:lang=\"en\">Post\u2010EVT OIS is rare, with an incidence of 1.7%. Absent OA opacification is 91% specific for OIS on pre\u2010EVT computed tomography angiography and 97% specific for OIS on post\u2010EVT DSA. Absent post\u2010EVT CB is 100% sensitive for OIS, with a worst\u2010case scenario specificity of 73%. These findings may help alert clinicians to potential OIS cases as well as determine the underlying cause of OIS.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/svin.123.001400","type":"journal-article","created":{"date-parts":[[2024,8,13]],"date-time":"2024-08-13T07:25:07Z","timestamp":1723533907000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Incidence of Orbital Infarction Syndrome Following Anterior Circulation Endovascular Thrombectomy"],"prefix":"10.1161","volume":"4","author":[{"given":"Michael","family":"MacMillan\u2010Wang","sequence":"first","affiliation":[{"name":"Department of Radiology University of Manitoba Winnipeg Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Alcock","sequence":"additional","affiliation":[{"name":"Department of Radiology University of Manitoba Winnipeg Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anurag","family":"Trivedi","sequence":"additional","affiliation":[{"name":"Department of Radiology University of Manitoba Winnipeg Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3707-9723","authenticated-orcid":false,"given":"Jai Jai Shiva","family":"Shankar","sequence":"additional","affiliation":[{"name":"Department of Radiology University of Manitoba Winnipeg Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0161-6420(93)31606-4"},{"key":"e_1_3_2_3_2","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1016\/j.wneu.2018.06.082","article-title":"Orbital infarction syndrome following mechanical thrombectomy secondary to embolization in new territory","volume":"117","author":"Brinjikji W","year":"2018","unstructured":"Brinjikji W, Nicholson PJ, Hilditch CA, Tsang COA, Krings T. Orbital infarction syndrome following mechanical thrombectomy secondary to embolization in new territory. World Neurosurg. 2018;117:326\u2010329. https:\/\/doi.org\/10.1016\/j.wneu.2018.06.082","journal-title":"World Neurosurg"},{"key":"e_1_3_2_4_2","doi-asserted-by":"crossref","first-page":"e111","DOI":"10.1097\/WNO.0000000000001659","article-title":"Orbital infarction syndrome as a rare complication after mechanical thrombectomy in ischemic stroke","volume":"44","author":"Rapillo CM","year":"2024","unstructured":"Rapillo CM, Donati MC, Renieri L, Lombardo, I., Addazio, I., Betti, M., Capasso, F., Capirossi, C., Giacomucci, G., Lamassa, M. Orbital infarction syndrome as a rare complication after mechanical thrombectomy in ischemic stroke. J Neuroophthalmol. 2024;44:e111\u2013e112.","journal-title":"J Neuroophthalmol"},{"key":"e_1_3_2_5_2","doi-asserted-by":"crossref","DOI":"10.1136\/bcr-2019-234158","article-title":"Orbital infarction syndrome after mechanical thrombectomy in acute ischaemic stroke","volume":"13","author":"Valls Carb\u00f3 A","year":"2020","unstructured":"Valls Carb\u00f3 A, Guti\u00e9rrez S\u00e1nchez de la Fuente M, P\u00e9rez Garc\u00eda C, G\u00f3mez Ruiz MN. Orbital infarction syndrome after mechanical thrombectomy in acute ischaemic stroke. BMJ Case Rep. 2020;13:e234158. https:\/\/doi.org\/10.1136\/bcr\u20102019\u2010234158","journal-title":"BMJ Case Rep"},{"key":"e_1_3_2_6_2","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1159\/000116650","article-title":"Isolated complete orbital infarction: a common carotid artery occlusion syndrome","volume":"31","author":"Bogousslavsky J","year":"1991","unstructured":"Bogousslavsky J, Pedrazzi PL, Borruat FX, Regli F. 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