{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T14:17:08Z","timestamp":1783693028711,"version":"3.55.0"},"reference-count":17,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"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":["SVIN"],"published-print":{"date-parts":[[2026,7]]},"abstract":"\n BACKGROUND:<\/jats:title>\n Final infarct volume (FIV) on 24-hour magnetic resonance imaging is a well-established imaging biomarker linked to functional recovery after ischemic stroke, yet its prognostic value in intracranial atherosclerosis\u2013related large vessel occlusion remains poorly explored. The impact of adjunct intracranial stenting on both infarct size and progression also remains unclear in this population. This study aimed to examine the association between FIV and clinical outcome, evaluate the effect of adjunct stenting on FIV and infarct progression, and assess the relationship between infarct progression and functional independence.<\/jats:p>\n <\/jats:sec>\n \n METHODS:<\/jats:title>\n We conducted a post hoc secondary analysis of the RESCUE-ICAS registry (Registry of Emergent Large Vessel Occlusion due to Intracranial Stenosis); only patients with anterior circulation large vessel occlusion with magnetic resonance imaging after thrombectomy were included. FIV was measured on diffusion-weighted magnetic resonance imaging performed 24 to 36 hours postthrombectomy. Infarct progression was defined as the difference between baseline computed tomography perfusion infarct volume (cerebral blood flow <30%) on presentation and 24- to 36-hour FIV. The primary outcome was 90-day functional independence (modified Rankin Scale score 0\u20132). Additional analyses evaluated the association between adjunct intracranial stenting and FIV, and the association between infarct progression and 90-day functional outcome. Associations were analyzed using multivariable logistic regression and inverse probability of treatment weighting.<\/jats:p>\n <\/jats:sec>\n \n RESULTS:<\/jats:title>\n \n Of the 417 patients included in RESCUE-ICAS, 203 had anterior circulation intracranial atherosclerosis\u2013related large vessel occlusion and underwent magnetic resonance imaging 24 to 36 hours postthrombectomy. Among these, 80 patients (39%) received adjunct stenting. FIV was independently associated with 90-day functional independence (adjusted odds ratio per 10\u2009mL increase, 0.8 [95% CI, 0.68\u20130.94];\n P<\/jats:italic>\n =0.007). Adjunct stenting was associated with a significant relative reduction in FIV, with inverse probability of treatment weighting\u2013adjusted analyses demonstrating a 37.8% lower FIV compared with no stenting (\n \u03b2<\/jats:italic>\n =\u22120.47 [95% CI, \u22120.93 to \u22120.02];\n P<\/jats:italic>\n =0.043). Among 108 patients with baseline computed tomography perfusion data, infarct progression was strongly associated with outcome, with each additional 10\u2009mL associated with \u224825% lower odds of achieving modified Rankin Scale score 0 to 2 at 90 days (adjusted odds ratio, 0.74 [95% CI, 0.60\u20130.90];\n P<\/jats:italic>\n =0.004), although infarct progression did not differ significantly between stented and nonstented groups (\u0394 \u22129.53 mL [95% CI \u221237.9 to 18.8];\n P<\/jats:italic>\n =0.506). In inverse probability of treatment weighting\u2013weighted models adjusted for successful recanalization, stenting was not independently associated with reduced FIV (\n \u03b2<\/jats:italic>\n =\u22120.41;\n P<\/jats:italic>\n =0.066), but remained independently associated with higher odds of 90-day functional independence (odds ratio, 2.29 [95% CI, 1.24\u20134.27];\n P<\/jats:italic>\n =0.008).\n <\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS:<\/jats:title>\n Among intracranial atherosclerosis\u2013related large vessel occlusion patients, 24- to 36-hour FIV is a strong predictor of functional outcome. Adjunct stenting is associated with smaller FIV. Lower infarct progression was also associated with favorable outcome. These findings highlight FIV as a reliable imaging biomarker and potential surrogate end point in future trials.<\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/svin.125.002105","type":"journal-article","created":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T09:01:46Z","timestamp":1781686906000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Final Infarct Volume as a Surrogate End Point in Anterior Circulation ICAS-LVO Stroke: Post Hoc Secondary Analysis of RESCUE-ICAS"],"prefix":"10.1161","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-8616-1712","authenticated-orcid":true,"given":"Ahmad","family":"Abu Qdais","sequence":"first","affiliation":[{"name":"Department of Neurology (A.A.Q.), Medical University of South Carolina, Charleston."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5636-0599","authenticated-orcid":true,"given":"Mustafa","family":"Ismail","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery (M.I., A. Abdelwahab, A.M.S., K.K., J.L., Z.H., S.A.K.), Medical University of South Carolina, Charleston."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-3834-790X","authenticated-orcid":true,"given":"Ahmed","family":"Abdelwahab","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery (M.I., A. Abdelwahab, A.M.S., K.K., J.L., Z.H., S.A.K.), Medical University of South Carolina, Charleston."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6873-7901","authenticated-orcid":true,"given":"Eyad","family":"Almallouhi","sequence":"additional","affiliation":[{"name":"Neurointerventional Surgery, Sarasota Memorial Hospital, FL (E.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0031-1004","authenticated-orcid":true,"given":"Shadi","family":"Yaghi","sequence":"additional","affiliation":[{"name":"Department of Neurology (S.Y.), Warren Alpert Medical School of Brown University, Providence, RI."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0399-3346","authenticated-orcid":true,"given":"Violiza","family":"Inoa-Acosta","sequence":"additional","affiliation":[{"name":"Semmes Murphey Clinic, University of Tennessee Health Science Center, Memphis (V.I.-A., N.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1087-6092","authenticated-orcid":true,"given":"Francesco","family":"Capasso","sequence":"additional","affiliation":[{"name":"Interventional Neuroradiology Department, Florence, Italy (F.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8198-7676","authenticated-orcid":true,"given":"Michael","family":"Nahhas","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Texas, Houston (M.N.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert M.","family":"Starke","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Miami, FL (R.M.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7037-7458","authenticated-orcid":true,"given":"Isabel","family":"Fragata","sequence":"additional","affiliation":[{"name":"Department of Neuroradiology, Hospital S. Jos\u00e9, ULS, Lisbon, Portugal (I.F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew T.","family":"Bender","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Rochester Medical Center, NY (M.T.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3415-9656","authenticated-orcid":true,"given":"Krisztina","family":"Moldovan","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery (K.M.), Warren Alpert Medical School of Brown University, Providence, RI."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6988-8878","authenticated-orcid":true,"given":"Ilko","family":"Maier","sequence":"additional","affiliation":[{"name":"Department of Neurology, University Medicine Goettingen, NS, Germany (I.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1152-8826","authenticated-orcid":true,"given":"Jonathan A.","family":"Grossberg","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Emory University, Atlanta, GA (J.A.G., A. Alawieh)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8965-2413","authenticated-orcid":true,"given":"Pascal","family":"Jabbour","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Thomas Jefferson University, Philadelphia, PA (P.J., S.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0016-414X","authenticated-orcid":true,"given":"Marios","family":"Psychogios","sequence":"additional","affiliation":[{"name":"Department of Neuroradiology, Clinic of Radiology and Nuclear Medicine, University Hospital Basel, Switzerland (M.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2764-2268","authenticated-orcid":true,"given":"Edgar A.","family":"Samaniego","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Iowa Hospitals and Clinics (E.A.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8381-0313","authenticated-orcid":true,"given":"Jan-Karl","family":"Burkhardt","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Pennsylvania, Philadelphia (J.-K.B., B.J.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9306-0763","authenticated-orcid":true,"given":"Brian","family":"Jankowitz","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Pennsylvania, Philadelphia (J.-K.B., B.J.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9528-301X","authenticated-orcid":true,"given":"Mohamad","family":"Abdalkader","sequence":"additional","affiliation":[{"name":"Department of Radiology (M. Abdalkader), Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, MA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashley","family":"Choi","sequence":"additional","affiliation":[{"name":"School of Medicine (A.C.), Medical University of South Carolina, Charleston."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7148-7616","authenticated-orcid":true,"given":"Ameer E.","family":"Hassan","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Valley Baptist Medical Center, Harlingen, TX (A.E.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5130-1378","authenticated-orcid":true,"given":"David","family":"Altschul","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY (D.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin","family":"Mascitelli","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Texas Health and Science Center, San Antonio (J.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2958-3484","authenticated-orcid":true,"given":"Robert W.","family":"Regenhardt","sequence":"additional","affiliation":[{"name":"Neuroendovascular Program, Massachusetts General Hospital, Harvard University, Boston (R.W.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7603-2728","authenticated-orcid":true,"given":"Stacey","family":"Wolfe","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Wake Forest School of Medicine, Winston-Salem, NC (S.W.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7740-8774","authenticated-orcid":true,"given":"Mohamad","family":"Ezzeldin","sequence":"additional","affiliation":[{"name":"Neuroendovascular Surgery, HCA Houston Healthcare Kingwood, TX (M.E.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7280-7407","authenticated-orcid":true,"given":"Kaustubh","family":"Limaye","sequence":"additional","affiliation":[{"name":"Department of Neurology, Neurological Surgery, Radiology and Imaging Sciences, Indiana University, Indianapolis (K.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3830-9789","authenticated-orcid":true,"given":"Hosam","family":"Al Jehani","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, King Fahad Hospital of the University, Alkhobar, Saudi Arabia (H.A.J.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad H.","family":"Niazi","sequence":"additional","affiliation":[{"name":"Department of Neurology, Wellspan Health, York, PA (M.H.N.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4699-0922","authenticated-orcid":true,"given":"Nitin","family":"Goyal","sequence":"additional","affiliation":[{"name":"Semmes Murphey Clinic, University of Tennessee Health Science Center, Memphis (V.I.-A., N.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1054-9414","authenticated-orcid":true,"given":"Stavropoula","family":"Tjoumakaris","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Thomas Jefferson University, Philadelphia, PA (P.J., S.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2601-8850","authenticated-orcid":true,"given":"Ali","family":"Alawieh","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Emory University, Atlanta, GA (J.A.G., A. 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