{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T06:50:26Z","timestamp":1791355826248,"version":"4.3.1"},"reference-count":62,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate whether pre-treatment dual-phase computed tomography angiography (CTA) filling patterns are independently associated with reperfusion-related complications after late-window mechanical thrombectomy and whether they provide incremental prognostic value beyond conventional clinical and imaging variables.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a prospective single-center cohort study including 80 consecutive patients with anterior circulation large-vessel occlusion who underwent mechanical thrombectomy within 6\u201324\u2005h after stroke onset or last known well. Dual-phase CTA filling patterns were classified as good early filling, delayed filling, or persistent poor filling; delayed and persistent poor filling were combined for the primary analyses. The primary outcome was a composite of reperfusion-related complications within 72\u2005h, including hemorrhagic transformation \u2265HI2, malignant cerebral edema, or early neurological deterioration. Secondary outcomes were 90-day functional independence and all-cause mortality. Independent predictors were identified using Firth penalized logistic regression. Incremental model performance was evaluated using receiver operating characteristic analysis, bootstrap internal validation, reclassification metrics, and decision-curve analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Reperfusion-related complications occurred in 28 patients (35%) and were significantly more frequent in patients with delayed or poor filling than in those with good early filling (56% vs. 20%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001). Delayed or poor filling independently predicted reperfusion-related complications after adjustment for age, baseline NIHSS score, and ASPECTS (adjusted OR 3.97, 95% CI 1.22\u201314.10;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.022). Older age was also independently associated with increased risk (adjusted OR 2.14 per 10-year increase, 95% CI 1.24\u20134.12;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.005), whereas higher ASPECTS was protective (adjusted OR 0.35 per point, 95% CI 0.18\u20130.61;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001). The full model incorporating dual-phase CTA achieved excellent discrimination (AUC 0.895; optimism-corrected AUC 0.867). Addition of the dual-phase CTA filling pattern improved patient risk reclassification, although the increase in discrimination beyond the clinical-plus-ASPECTS model was not statistically significant. Patients with delayed or poor filling had substantially worse 90-day outcomes, including lower functional independence (24% vs. 70%) and higher mortality (38% vs. 4%) (both\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Delayed or persistent poor filling on dual-phase CTA is an independent imaging marker of reperfusion-related complications following late-window mechanical thrombectomy. Although its incremental contribution to model discrimination was modest, dual-phase CTA may improve early risk stratification and help identify patients who may benefit from intensified post-procedural monitoring. External validation is warranted before routine clinical implementation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1934591","type":"journal-article","created":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T05:59:57Z","timestamp":1791352797000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Dual-phase CTA filling pattern is associated with reperfusion-related complications after mechanical thrombectomy in late-window anterior circulation stroke"],"prefix":"10.3389","volume":"13","author":[{"given":"Truong Van","family":"Le","sequence":"first","affiliation":[{"name":"Department of Neurovascular Intervention, Institute of Neurology, 108 Military Central Hospital","place":["Hanoi, Vietnam"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khanh T. 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