{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T16:22:07Z","timestamp":1791044527237,"version":"4.1.0"},"reference-count":40,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2021,1,14]],"date-time":"2021-01-14T00:00:00Z","timestamp":1610582400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Cereb Blood Flow Metab"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:p>The generalization of perfusion-based, anterior circulation large vessel occlusion selection criteria to posterior circulation stroke is not straightforward due to physiologic delay, which we posit produces physiologic prolongation of the posterior circulation perfusion time-to-maximum (Tmax). To assess normative Tmax distributions, patients undergoing CTA\/CTP for suspected ischemic stroke between 1\/2018-3\/2019 were retrospectively identified. Subjects with any cerebrovascular stenoses, or with follow-up MRI or final clinical diagnosis of stroke were excluded. Posterior circulation anatomic variations were identified. CTP were processed in RAPID and segmented in a custom pipeline permitting manually-enforced arterial input function (AIF) and perfusion estimations constrained to pre-specified vascular territories. Seventy-one subjects (mean 64\u2009\u00b1\u200919\u2009years) met inclusion. Median Tmax was significantly greater in the cerebellar hemispheres (right: 3.0\u2009s, left: 2.9\u2009s) and PCA territories (right: 2.9\u2009s; left: 3.3\u2009s) than in the anterior circulation (right: 2.4\u2009s; left: 2.3\u2009s, p\u2009&lt;\u20090.001). Fetal PCA disposition eliminated ipsilateral PCA Tmax delays (p\u2009=\u20090.012). Median territorial Tmax was significantly lower with basilar versus any anterior circulation AIF for all vascular territories (p\u2009&lt;\u20090.001). Significant baseline delays in posterior circulation Tmax are observed even without steno-occlusive disease and vary with anatomic variation and AIF selection. The potential for overestimation of at-risk volumes in the posterior circulation merits caution in future trials.<\/jats:p>","DOI":"10.1177\/0271678x20982395","type":"journal-article","created":{"date-parts":[[2021,1,14]],"date-time":"2021-01-14T22:29:03Z","timestamp":1610663343000},"page":"1912-1923","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":27,"title":["Normative distribution of posterior circulation tissue time-to-maximum: Effects of anatomic variation, tracer kinetics, and implications for patient selection in posterior circulation ischemic stroke"],"prefix":"10.1177","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2236-5783","authenticated-orcid":false,"given":"Adam E","family":"Goldman-Yassen","sequence":"first","affiliation":[{"name":"Department of Radiology, New York University Langone Medical Center, New York, NY, USA"},{"name":"Department of Radiology, Children\u2019s Healthcare of 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