{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T00:21:42Z","timestamp":1790295702177,"version":"4.1.0"},"reference-count":51,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T00:00:00Z","timestamp":1765584000000},"content-version":"vor","delay-in-days":468,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2024,9,1]],"date-time":"2024-09-01T00:00:00Z","timestamp":1725148800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"MR CLEAN Registry was partly"},{"name":"MR CLEAN Registry was partly"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>To improve our understanding of the relatively poor outcome after endovascular treatment (EVT) in women we assessed possible sex differences in baseline neuroimaging characteristics of acute ischemic stroke patients with large anterior vessel occlusion (LVO).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and methods:<\/jats:title>\n                    <jats:p>We included all consecutive patients from the MR CLEAN Registry who underwent EVT between 2014 and 2017. On baseline non-contrast CT and CT angiography, we assessed clot location and clot burden score (CBS), vessel characteristics (presence of atherosclerosis, tortuosity, size, and collateral status), and tissue characteristics with the Alberta Stroke Program Early Computed Tomography Score (ASPECTS). Radiological outcome was assessed with the extended thrombolysis in cerebral infarction score (eTICI) and functional outcome with the modified Rankin Scale score (mRS) at 90\u2009days. Sex-differences were assessed with multivariable regression analyses with adjustments for possible confounders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>3180 patients were included (median age 72\u2009years, 48% women). Clots in women were less often located in the intracranial internal carotid artery (ICA) (25%vs 28%, odds ratio (OR) 0.85;95% confidence interval: 0.73\u20131.00). CBS was similar between sexes (median 6, IQR 4\u20138). Intracranial (aOR 0.73;95% CI:0.62\u20130.87) and extracranial (aOR 0.64;95% CI:0.43\u20130.95) atherosclerosis was less prevalent in women. Vessel tortuosity was more frequent in women in the cervical ICA (aOR 1.89;95% CI:1.39\u20132.57) and women more often had severe elongation of the aortic arch (aOR 1.38;95% CI:1.00\u20131.91). ICA radius was smaller in women (2.3vs 2.5\u2009mm, mean difference 0.22;95% CI:0.09\u20130.35) while M1 radius was essentially equal (1.6vs 1.7\u2009mm, mean difference 0.09;95% CI:\u22120.02\u20130.21). Women had better collateral status (\u2a7e50% filling in 62%vs 53% in men, aOR 1.48;95% CI:1.29\u20131.70). Finally, ASPECT scores were equal between women and men (median 9 in both sexes, IQR 8\u201310vs 9\u201310). Reperfusion rates were similar between women and men (acOR 0.94;95% CI:0.83\u20131.07). However, women less often reached functional independence than men (34%vs 46%, aOR 0.68;95% CI:0.53\u20130.86).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion and conclusion:<\/jats:title>\n                    <jats:p>On baseline imaging of this Dutch Registry, men and women with LVO mainly differ in vessel characteristics such as atherosclerotic burden, extracranial vessel tortuosity, and collateral status. These sex differences do not result in different reperfusion rates and are, therefore, not likely to explain the worse functional outcome in women after EVT.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/23969873241231125","type":"journal-article","created":{"date-parts":[[2024,2,29]],"date-time":"2024-02-29T07:55:17Z","timestamp":1709193317000},"page":"600-612","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":8,"title":["Sex differences in clot, vessel and tissue characteristics in patients with a large vessel occlusion treated with endovascular thrombectomy"],"prefix":"10.1093","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8661-1213","authenticated-orcid":false,"given":"Anne","family":"van der Meij","sequence":"first","affiliation":[{"name":"Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands 1"},{"name":"Department of Neurology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands 2"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9788-4345","authenticated-orcid":false,"given":"Ghislaine","family":"Holswilder","sequence":"additional","affiliation":[{"name":"Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands 3"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie Louise E","family":"Bernsen","sequence":"additional","affiliation":[{"name":"Department of Radiology and Nuclear Medicine, Rijnstate Hospital, Arnhem, The Netherlands 4"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hendrikus JA","family":"van Os","sequence":"additional","affiliation":[{"name":"Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands 1"},{"name":"Department of Public Health & Primary Care, Leiden University Medical Center, Leiden, The Netherlands 5"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeannette","family":"Hofmeijer","sequence":"additional","affiliation":[{"name":"Department of Neurology, Rijnstate Hospital, Arnhem, The Netherlands 6"},{"name":"Department of Clinical Neurophysiology, University of Twente, Enschede, The Netherlands 7"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fianne HM","family":"Spaander","sequence":"additional","affiliation":[{"name":"Department of Neurology, Zaans Medical Center, Zaandam, The Netherlands 8"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9418-4503","authenticated-orcid":false,"given":"Jasper M","family":"Martens","sequence":"additional","affiliation":[{"name":"Department of Radiology and Nuclear Medicine, Rijnstate Hospital, Arnhem, The Netherlands 4"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ido R","family":"van den Wijngaard","sequence":"additional","affiliation":[{"name":"Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands 1"},{"name":"Department of Neurology, Haaglanden Medical Center, Den Haag, The Netherlands 9"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hester F","family":"Lingsma","sequence":"additional","affiliation":[{"name":"Department of Public Health, Erasmus MC University Medical Center, Rotterdam, The Netherlands 10"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9911-2090","authenticated-orcid":false,"given":"Praneeta R","family":"Konduri","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering and Physics, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands 11"},{"name":"Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands 12"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"BLM Majoie","sequence":"additional","affiliation":[{"name":"Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands 12"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wouter J","family":"Schonewille","sequence":"additional","affiliation":[{"name":"Department of Neurology, Sint Antonius Hospital, Nieuwegein, The Netherlands 13"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diederik WJ","family":"Dippel","sequence":"additional","affiliation":[{"name":"Department of Neurology, Erasmus MC University Medical Center, Rotterdam, The Netherlands 14"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2320-0932","authenticated-orcid":false,"given":"Nyika D","family":"Kruyt","sequence":"additional","affiliation":[{"name":"Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands 1"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul J","family":"Nederkoorn","sequence":"additional","affiliation":[{"name":"Department of Neurology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands 2"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianne AA","family":"van Walderveen","sequence":"additional","affiliation":[{"name":"Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands 3"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marieke JH","family":"Wermer","sequence":"additional","affiliation":[{"name":"Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands 1"},{"name":"Department of Neurology, University Medical Center Groningen, Groningen, The Netherlands 15"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"on behalf of the MR CLEAN Registry 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