{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T23:27:27Z","timestamp":1778628447969,"version":"3.51.4"},"reference-count":13,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2023,1,23]],"date-time":"2023-01-23T00:00:00Z","timestamp":1674432000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100016015","name":"Universit\u00e4tsspital Basel","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100016015","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["European Stroke Journal"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Computed tomography angiography (CTA) of the supraaortic arteries is commonly used for acute stroke workup and may reveal apical pulmonary lesions (APL).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim:<\/jats:title>\n                    <jats:p>To determine the prevalence, follow-up algorithms, and in-hospital outcomes of stroke patients with APL on CTA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We retrospectively included consecutive adult patients with ischemic stroke, transient ischemic attack, or intracerebral hemorrhage and available CTA at a tertiary hospital between January 2014 and May 2021. We reviewed all CTA reports for the presence of APL. APL were classified as malignancy suspicious or benign appearing based on radiological-morphological criteria. We performed regression analyses to investigate the impact of malignancy suspicious APL on different in-hospital outcome parameters.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Among 2715 patients, APL on CTA were found in 161 patients (5.9% [95%CI: 5.1\u20136.9]; 161\/2715). Suspicion of malignancy was present in one third of patients with APL (36.0% [95%CI: 29.0\u201343.7]; 58\/161), 42 of whom (72.4% [95%CI: 60.0\u201382.2]; 42\/58) had no history of lung cancer or metastases. When performed, further investigations confirmed primary or secondary pulmonary malignancy in three-quarters (75.0% [95%CI: 50.5\u201389.8]; 12\/16), with two patients (16.7% [95%CI: 4.7\u201344.8]; 2\/12) receiving de novo oncologic therapy. In multivariable regression, the presence of radiologically malignancy suspicious APL was associated with higher NIHSS scores at 24\u2009h (beta\u2009=\u20090.67, 95%CI: 0.28\u20131.06,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001) and all-cause in-hospital mortality (aOR\u2009=\u20093.83, 95%CI: 1.29\u20139.94,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>One in seventeen patients shows APL on CTA, of which one-third is malignancy suspicious. Further work-up confirmed pulmonary malignancy in a substantial number of patients triggering potentially life-saving oncologic therapy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/23969873231151488","type":"journal-article","created":{"date-parts":[[2023,1,23]],"date-time":"2023-01-23T05:38:38Z","timestamp":1674452318000},"page":"549-556","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":6,"title":["Apical pulmonary lesions suspected of malignancy visible on neck CT angiography performed for acute stroke: Prevalence, treatment, and clinical implications \u2013 the PLEURA study"],"prefix":"10.1093","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9987-3631","authenticated-orcid":false,"given":"Tolga D","family":"Dittrich","sequence":"first","affiliation":[{"name":"Department of Neurology and Stroke Center, University Hospital Basel, Basel, Switzerland"},{"name":"Department of Clinical Research, University of Basel, Basel, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mara","family":"Aujesky","sequence":"additional","affiliation":[{"name":"Department of Neurology and Stroke Center, University Hospital Basel, Basel, Switzerland"},{"name":"Department of Clinical Research, University of Basel, Basel, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Salome","family":"Rudin","sequence":"additional","affiliation":[{"name":"Department of Neurology and Stroke Center, University Hospital Basel, Basel, Switzerland"},{"name":"Department of Clinical Research, University of Basel, Basel, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annaelle","family":"Zietz","sequence":"additional","affiliation":[{"name":"Department of Neurology and Stroke Center, University Hospital Basel, Basel, Switzerland"},{"name":"Department of Clinical Research, University of Basel, Basel, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9330-1790","authenticated-orcid":false,"given":"Benjamin","family":"Wagner","sequence":"additional","affiliation":[{"name":"Department of Neurology and Stroke Center, University Hospital Basel, Basel, Switzerland"},{"name":"Department of Clinical Research, University of Basel, Basel, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9475-2208","authenticated-orcid":false,"given":"Alexandros","family":"Polymeris","sequence":"additional","affiliation":[{"name":"Department of Neurology and Stroke Center, University Hospital Basel, Basel, Switzerland"},{"name":"Department of Clinical Research, University of Basel, Basel, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valerian L","family":"Altersberger","sequence":"additional","affiliation":[{"name":"Department of Neurology and Stroke Center, University Hospital Basel, Basel, Switzerland"},{"name":"Department of Clinical Research, University of Basel, Basel, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tim","family":"Sinnecker","sequence":"additional","affiliation":[{"name":"Department of Neurology and Stroke Center, University Hospital Basel, Basel, Switzerland"},{"name":"Department of Clinical Research, University of Basel, Basel, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henrik","family":"Gensicke","sequence":"additional","affiliation":[{"name":"Department of Neurology and Stroke Center, University Hospital Basel, Basel, Switzerland"},{"name":"Department of Clinical Research, University of Basel, Basel, Switzerland"},{"name":"Neurology and Neurorehabilitation, University Department of Geriatric Medicine Felix Platter, University of Basel, Basel, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefan T","family":"Engelter","sequence":"additional","affiliation":[{"name":"Department of Neurology and Stroke Center, University Hospital Basel, Basel, Switzerland"},{"name":"Department of Clinical Research, University of Basel, Basel, Switzerland"},{"name":"Neurology and Neurorehabilitation, University Department of Geriatric Medicine Felix Platter, University of Basel, Basel, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philippe","family":"Lyrer","sequence":"additional","affiliation":[{"name":"Department of Neurology and Stroke Center, University Hospital Basel, Basel, Switzerland"},{"name":"Department of Clinical Research, University of Basel, Basel, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Viviane","family":"Hess","sequence":"additional","affiliation":[{"name":"Department of Clinical Research, University of Basel, Basel, Switzerland"},{"name":"Department of Oncology, University Hospital Basel and University of Basel, Basel, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raoul","family":"Sutter","sequence":"additional","affiliation":[{"name":"Department of Clinical Research, University of Basel, Basel, Switzerland"},{"name":"Department of Intensive Care Medicine, University Hospital and University of Basel, Basel, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian H","family":"Nickel","sequence":"additional","affiliation":[{"name":"Department of Clinical Research, University of Basel, Basel, Switzerland"},{"name":"Emergency Department, University Hospital Basel and University of Basel, Basel, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leo H","family":"Bonati","sequence":"additional","affiliation":[{"name":"Department of Neurology and Stroke Center, University Hospital Basel, Basel, Switzerland"},{"name":"Department of Clinical Research, University of Basel, Basel, Switzerland"},{"name":"Rehabilitation 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The undiagnosed potential clinically significant incidental findings of neck CTA: a large retrospective single-center study. 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