{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T14:17:10Z","timestamp":1787235430020,"version":"build-2736575974"},"reference-count":48,"publisher":"SAGE Publications","issue":"12","license":[{"start":{"date-parts":[[2025,7,28]],"date-time":"2025-07-28T00:00:00Z","timestamp":1753660800000},"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":[[2025,12]]},"abstract":"<jats:p>\n                    Aneurysmal subarachnoid hemorrhage (aSAH) contributes disproportionately to stroke-related disability due to its prevalence in younger patients. Large vessel vasospasm complicates aSAH and is often treated with endovascular rescue therapy (ERT). However, clinical trials have not demonstrated a clear link between vasospasm improvement and better outcomes. We hypothesized that improving vessel caliber alone may not ensure better blood flow to brain parenchyma, and we studied how vessel caliber relates to perfusion in the context of ERT. We measured the internal carotid artery (ICA) caliber and time to maximum of the residual function (Tmax) from digital subtraction angiography (DSA) before and after ERT in 150 vessels from 36 patients. ERT increased ICA caliber (\u03941.13\u2009\u00b1\u20093.8\u2009mm\n                    <jats:sup>2<\/jats:sup>\n                    , p\u2009&lt;\u20090.01) and accelerated mean Tmax (\u0394-215\u2009\u00b1\u2009483\u2009ms, p\u2009&lt;\u20090.01). The percent change in ICA caliber with ERT was weakly correlated with the change in Tmax (R\n                    <jats:sup>2<\/jats:sup>\n                    \u2009=\u20090.04, p\u2009&lt;\u20090.01). In contrast, Tmax before ERT strongly predicted Tmax after ERT (R\n                    <jats:sup>2<\/jats:sup>\n                    \u2009=\u20090.62, p\u2009&lt;\u20090.01) in both univariate and multivariable models. We conclude that a perfusion metric (Tmax) is superior to vessel caliber in predicting the response to ERT. Validating these findings may shift the clinical focus from vessel caliber to perfusion metrics when evaluating vasospasm and aSAH outcomes.\n                  <\/jats:p>","DOI":"10.1177\/0271678x251361992","type":"journal-article","created":{"date-parts":[[2025,7,28]],"date-time":"2025-07-28T13:56:26Z","timestamp":1753710986000},"page":"2404-2416","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Angiographic perfusion outperforms large artery vasospasm for predicting the impact of rescue therapy in subarachnoid hemorrhage"],"prefix":"10.1177","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3309-7211","authenticated-orcid":false,"given":"Kyle A","family":"Lyman","sequence":"first","affiliation":[{"name":"Massachusetts General Hospital"},{"name":"Massachusetts General Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel B","family":"Rubin","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital"},{"name":"Center for Neurotechnology and Neurorecovery, Massachusetts General Hospital, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert W","family":"Regenhardt","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA"},{"name":"Massachusetts General Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew J","family":"Webb","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guy A","family":"Rordorf","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian L","family":"Edlow","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital"},{"name":"Center for Neurotechnology and Neurorecovery, Massachusetts General Hospital, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W Taylor","family":"Kimberly","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rose","family":"Du","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel B","family":"Snider","sequence":"additional","affiliation":[{"name":"Division of Neurocritical Care, Department of Neurology, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher J","family":"Stapleton","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aman B","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph J","family":"Locascio","sequence":"additional","affiliation":[{"name":"Harvard Catalyst Statistical Consulting Group and Neurology Dept., Massachusetts General Hospital\/Harvard Medical School, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew B","family":"Bevers","sequence":"additional","affiliation":[{"name":"Division of Neurocritical Care, Department of Neurology, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, MA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ona","family":"Wu","sequence":"additional","affiliation":[{"name":"Athinoula A. 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