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<meta name="DC.Title" content="Reasons for Reperfusion Failures in Stent-Retriever-Based Thrombectomy: Registry Analysis and Proposal of a Classification System" />
<meta name="DC.Identifier" content="10.3174/ajnr.A5759" />
<meta name="DC.Date" content="2018-10-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
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<meta name="DC.AccessRights" content="open-access" />
<meta name="DC.Description" content="BACKGROUND AND PURPOSE: In 5%–10% of patients with acute ischemic stroke with an intention to treat with mechanical thrombectomy, no reperfusion can be achieved (Thrombolysis in Cerebral Infarction score = 0/1). Purpose of this analysis was a systematic assessment of underlying reasons for reperfusion failures.

MATERIALS AND METHODS: An intention-to-treat single-center cohort ( n = 592) was re-evaluated for all patients in whom no reperfusion could be achieved ( n = 63). Baseline characteristics of patients were compared between patients with and without reperfusion failures. After qualitative review of all cases with reperfusion failures, a classification system was proposed and relative frequencies were reported. In a second step, occurrence of delayed recanalization at 24 hours after reperfusion failure and dependency on IV-tPA were evaluated.

RESULTS: In 63/592 patients with an intention to perform stent-retriever thrombectomy, no reperfusion was achieved (TICI 0/1, 10.6%, 95% CI, 8.2%–13.1%). Older patients (adjusted OR per yr = 1.03; 95% CI, 1.01–1.05) and patients with M2 occlusion (adjusted OR = 3.36; 95% CI, 1.82–6.21) were at higher risk for reperfusion failure. In most cases, no reperfusion was a consequence of technical difficulties (56/63, 88.9%). In one-third of these cases, reperfusion failures were due to the inability to reach the target occlusion (20/63, 31.7%), while “stent-retriever failure” occurred in 39.7% (25/63) of patients. Delayed recanalization was very rare (18.2%), without dependence on IV-tPA pretreatment status.

CONCLUSIONS: Reasons for reperfusion failure in stent-retriever thrombectomy are heterogeneous. The failure to establish intracranial or cervical access is almost as common as stent-retriever failure after establishing intracranial access. Systematic reporting standards of reasons may help to further estimate relative frequencies and thereby guide priorities for technical development and scientific effort." />
<meta name="DC.Contributor" content="J. Kaesmacher" />
<meta name="DC.Contributor" content="J. Gralla" />
<meta name="DC.Contributor" content="P.J. Mosimann" />
<meta name="DC.Contributor" content="F. Zibold" />
<meta name="DC.Contributor" content="M.R. Heldner" />
<meta name="DC.Contributor" content="E. Piechowiak" />
<meta name="DC.Contributor" content="T. Dobrocky" />
<meta name="DC.Contributor" content="M. Arnold" />
<meta name="DC.Contributor" content="U. Fischer" />
<meta name="DC.Contributor" content="P. Mordasini" />
<meta name="article:published_time" content="2018-10-01" />
<meta name="article:section" content="Interventional" />
<meta name="citation_title" content="Reasons for Reperfusion Failures in Stent-Retriever-Based Thrombectomy: Registry Analysis and Proposal of a Classification System" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;In 5%–10% of patients with acute ischemic stroke with an intention to treat with mechanical thrombectomy, no reperfusion can be achieved (Thrombolysis in Cerebral Infarction score = 0/1). Purpose of this analysis was a systematic assessment of underlying reasons for reperfusion failures.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;An intention-to-treat single-center cohort (&lt;i&gt;n&lt;/i&gt; = 592) was re-evaluated for all patients in whom no reperfusion could be achieved (&lt;i&gt;n&lt;/i&gt; = 63). Baseline characteristics of patients were compared between patients with and without reperfusion failures. After qualitative review of all cases with reperfusion failures, a classification system was proposed and relative frequencies were reported. In a second step, occurrence of delayed recanalization at 24 hours after reperfusion failure and dependency on IV-tPA were evaluated.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;In 63/592 patients with an intention to perform stent-retriever thrombectomy, no reperfusion was achieved (TICI 0/1, 10.6%, 95% CI, 8.2%–13.1%). Older patients (adjusted OR per yr = 1.03; 95% CI, 1.01–1.05) and patients with M2 occlusion (adjusted OR = 3.36; 95% CI, 1.82–6.21) were at higher risk for reperfusion failure. In most cases, no reperfusion was a consequence of technical difficulties (56/63, 88.9%). In one-third of these cases, reperfusion failures were due to the inability to reach the target occlusion (20/63, 31.7%), while “stent-retriever failure” occurred in 39.7% (25/63) of patients. Delayed recanalization was very rare (18.2%), without dependence on IV-tPA pretreatment status.&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;Reasons for reperfusion failure in stent-retriever thrombectomy are heterogeneous. The failure to establish intracranial or cervical access is almost as common as stent-retriever failure after establishing intracranial access. Systematic reporting standards of reasons may help to further estimate relative frequencies and thereby guide priorities for technical development and scientific effort.&lt;/p&gt;" />
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<meta name="twitter:title" content="Reasons for Reperfusion Failures in Stent-Retriever-Based Thrombectomy: Registry Analysis and Proposal of a Classification System" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: In 5%–10% of patients with acute ischemic stroke with an intention to treat with mechanical thrombectomy, no reperfusion can be achieved (Thrombolysis in Cerebral Infarction score = 0/1). Purpose of this analysis was a systematic assessment of underlying reasons for reperfusion failures.

MATERIALS AND METHODS: An intention-to-treat single-center cohort ( n = 592) was re-evaluated for all patients in whom no reperfusion could be achieved ( n = 63). Baseline characteristics of patients were compared between patients with and without reperfusion failures. After qualitative review of all cases with reperfusion failures, a classification system was proposed and relative frequencies were reported. In a second step, occurrence of delayed recanalization at 24 hours after reperfusion failure and dependency on IV-tPA were evaluated.

RESULTS: In 63/592 patients with an intention to perform stent-retriever thrombectomy, no reperfusion was achieved (TICI 0/1, 10.6%, 95% CI, 8.2%–13.1%). Older patients (adjusted OR per yr = 1.03; 95% CI, 1.01–1.05) and patients with M2 occlusion (adjusted OR = 3.36; 95% CI, 1.82–6.21) were at higher risk for reperfusion failure. In most cases, no reperfusion was a consequence of technical difficulties (56/63, 88.9%). In one-third of these cases, reperfusion failures were due to the inability to reach the target occlusion (20/63, 31.7%), while “stent-retriever failure” occurred in 39.7% (25/63) of patients. Delayed recanalization was very rare (18.2%), without dependence on IV-tPA pretreatment status.

CONCLUSIONS: Reasons for reperfusion failure in stent-retriever thrombectomy are heterogeneous. The failure to establish intracranial or cervical access is almost as common as stent-retriever failure after establishing intracranial access. Systematic reporting standards of reasons may help to further estimate relative frequencies and thereby guide priorities for technical development and scientific effort." />
<meta name="og-title" property="og:title" content="Reasons for Reperfusion Failures in Stent-Retriever-Based Thrombectomy: Registry Analysis and Proposal of a Classification System" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/39/10/1848" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: In 5%–10% of patients with acute ischemic stroke with an intention to treat with mechanical thrombectomy, no reperfusion can be achieved (Thrombolysis in Cerebral Infarction score = 0/1). Purpose of this analysis was a systematic assessment of underlying reasons for reperfusion failures.

MATERIALS AND METHODS: An intention-to-treat single-center cohort ( n = 592) was re-evaluated for all patients in whom no reperfusion could be achieved ( n = 63). Baseline characteristics of patients were compared between patients with and without reperfusion failures. After qualitative review of all cases with reperfusion failures, a classification system was proposed and relative frequencies were reported. In a second step, occurrence of delayed recanalization at 24 hours after reperfusion failure and dependency on IV-tPA were evaluated.

RESULTS: In 63/592 patients with an intention to perform stent-retriever thrombectomy, no reperfusion was achieved (TICI 0/1, 10.6%, 95% CI, 8.2%–13.1%). Older patients (adjusted OR per yr = 1.03; 95% CI, 1.01–1.05) and patients with M2 occlusion (adjusted OR = 3.36; 95% CI, 1.82–6.21) were at higher risk for reperfusion failure. In most cases, no reperfusion was a consequence of technical difficulties (56/63, 88.9%). In one-third of these cases, reperfusion failures were due to the inability to reach the target occlusion (20/63, 31.7%), while “stent-retriever failure” occurred in 39.7% (25/63) of patients. Delayed recanalization was very rare (18.2%), without dependence on IV-tPA pretreatment status.

CONCLUSIONS: Reasons for reperfusion failure in stent-retriever thrombectomy are heterogeneous. The failure to establish intracranial or cervical access is almost as common as stent-retriever failure after establishing intracranial access. Systematic reporting standards of reasons may help to further estimate relative frequencies and thereby guide priorities for technical development and scientific effort." />
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    <div class="highwire-article-citation highwire-citation-type-highwire-article node63209--5" data-node-nid="63209" id="top-node-63209--6484843042" data-pisa="ajnr;39/10/1848" data-pisa-master="ajnr;ajnr.A5759" data-apath="/ajnr/39/10/1848.atom" data-hw-author-tooltip-instance="highwire_author_tooltip"><div class="highwire-cite highwire-cite-highwire-article highwire-citation-jcore-article-title-complete clearfix has-author-tooltip highwire-citation-highwire-article-top-a">
  
  
      <div class="highwire-cite-overline"><span  class="highwire-cite-metadata-article-type highwire-cite-metadata">Research Article</span><span class="separator-pipe"></span><span  class="highwire-cite-metadata-art-cat highwire-cite-metadata"><span class="wrapper">Interventional</span></span></div>
  
      <div class="highwire-cite-access"><span class="highwire-citation-access"><i class="highwire-access-icon highwire-access-icon-open-access open-access hw-icon-open-access" title="Open Access" aria-hidden="true"></i><span  class="element-invisible highwire-access-icon highwire-access-icon-open-access" style="">Open Access</span></span></div>
  
      <h1 class="highwire-cite-title" id="page-title">Reasons for Reperfusion Failures in Stent-Retriever-Based Thrombectomy: Registry Analysis and Proposal of a Classification System</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">J. Kaesmacher</span>, <span class="highwire-citation-author" data-delta="1">J. Gralla</span>, <span class="highwire-citation-author" data-delta="2">P.J. Mosimann</span>, <span class="highwire-citation-author" data-delta="3">F. Zibold</span>, <span class="highwire-citation-author" data-delta="4">M.R. Heldner</span>, <span class="highwire-citation-author" data-delta="5">E. Piechowiak</span>, <span class="highwire-citation-author" data-delta="6">T. Dobrocky</span>, <span class="highwire-citation-author" data-delta="7">M. Arnold</span>, <span class="highwire-citation-author" data-delta="8">U. Fischer</span> and <span class="highwire-citation-author" data-delta="9">P. Mordasini</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">October 2018,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">39 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(10) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1848-1853; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A5759 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-63209--6484843042" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">J. Kaesmacher </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the University Institute of Diagnostic and Interventional Neuroradiology (J.K., J.G., P.J. Mosimann, F.Z., E.P., T.D., P. Mordasini)</div><div class='author-affiliation'><span class='nlm-sup'>b</span>Department of Neurology (J.K., M.R.H., M.A., U.F.), University Hospital Bern and University of Bern, Inselspital, Bern, Switzerland.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=J.%2BKaesmacher%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Kaesmacher%20J&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AJ.%2BKaesmacher%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-9177-2289" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for J. Kaesmacher</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">J. Gralla </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the University Institute of Diagnostic and Interventional Neuroradiology (J.K., J.G., P.J. Mosimann, F.Z., E.P., T.D., P. Mordasini)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=J.%2BGralla%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Gralla%20J&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AJ.%2BGralla%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0003-1953-9033" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for J. Gralla</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">P.J. Mosimann </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the University Institute of Diagnostic and Interventional Neuroradiology (J.K., J.G., P.J. Mosimann, F.Z., E.P., T.D., P. Mordasini)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=P.J.%2BMosimann%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Mosimann%20P&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AP.J.%2BMosimann%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0001-5111-1972" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for P.J. Mosimann</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">F. Zibold </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the University Institute of Diagnostic and Interventional Neuroradiology (J.K., J.G., P.J. Mosimann, F.Z., E.P., T.D., P. Mordasini)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=F.%2BZibold%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Zibold%20F&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AF.%2BZibold%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-6578-0605" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for F. Zibold</a></li></ul></div><div class="author-tooltip-4"><div class="author-tooltip-name">M.R. Heldner </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Department of Neurology (J.K., M.R.H., M.A., U.F.), University Hospital Bern and University of Bern, Inselspital, Bern, Switzerland.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=M.R.%2BHeldner%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Heldner%20M&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AM.R.%2BHeldner%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-3594-2159" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for M.R. Heldner</a></li></ul></div><div class="author-tooltip-5"><div class="author-tooltip-name">E. Piechowiak </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the University Institute of Diagnostic and Interventional Neuroradiology (J.K., J.G., P.J. Mosimann, F.Z., E.P., T.D., P. Mordasini)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=E.%2BPiechowiak%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Piechowiak%20E&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AE.%2BPiechowiak%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0001-5609-0998" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for E. Piechowiak</a></li></ul></div><div class="author-tooltip-6"><div class="author-tooltip-name">T. Dobrocky </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the University Institute of Diagnostic and Interventional Neuroradiology (J.K., J.G., P.J. Mosimann, F.Z., E.P., T.D., P. Mordasini)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=T.%2BDobrocky%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Dobrocky%20T&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AT.%2BDobrocky%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-6167-3343" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for T. Dobrocky</a></li></ul></div><div class="author-tooltip-7"><div class="author-tooltip-name">M. Arnold </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Department of Neurology (J.K., M.R.H., M.A., U.F.), University Hospital Bern and University of Bern, Inselspital, Bern, Switzerland.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=M.%2BArnold%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Arnold%20M&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AM.%2BArnold%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-4274-4644" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for M. Arnold</a></li></ul></div><div class="author-tooltip-8"><div class="author-tooltip-name">U. Fischer </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Department of Neurology (J.K., M.R.H., M.A., U.F.), University Hospital Bern and University of Bern, Inselspital, Bern, Switzerland.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=U.%2BFischer%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Fischer%20U&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AU.%2BFischer%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0003-0521-4051" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for U. Fischer</a></li></ul></div><div class="author-tooltip-9"><div class="author-tooltip-name">P. Mordasini </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the University Institute of Diagnostic and Interventional Neuroradiology (J.K., J.G., P.J. Mosimann, F.Z., E.P., T.D., P. Mordasini)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=P.%2BMordasini%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Mordasini%20P&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AP.%2BMordasini%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0003-1712-4168" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for P. Mordasini</a></li></ul></div></div></div>  </div>

  
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    <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" xmlns:xhtml="http://www.w3.org/1999/xhtml" class="section ref-list" id="ref-list-1"><h2 class="">References</h2><ol class="cit-list ref-use-labels"><li><span class="ref-label">1.</span><a class="rev-xref-ref" href="#xref-ref-1-1" title="View reference 1. in text" id="ref-1">↵</a><div class="cit ref-cit ref-journal" id="cit-39.10.1848.1" data-doi="10.1016/S0140-6736(16)00163-X"><div class="cit-metadata"><ol class="cit-auth-list"><li>
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        	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-volume highwire-cite-metadata">Vol. 39</span>, <span  class="highwire-cite-metadata-issue highwire-cite-metadata">Issue 10 </span><div  class="highwire-cite-metadata-pubdate highwire-cite-metadata">1 Oct 2018 </div></div>
      
      
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    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">J.</span> <span class="nlm-surname">Kaesmacher</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">J.</span> <span class="nlm-surname">Gralla</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">P.J.</span> <span class="nlm-surname">Mosimann</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">F.</span> <span class="nlm-surname">Zibold</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">M.R.</span> <span class="nlm-surname">Heldner</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">E.</span> <span class="nlm-surname">Piechowiak</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">T.</span> <span class="nlm-surname">Dobrocky</span></span>, <span class="highwire-citation-author" data-delta="7"><span class="nlm-given-names">M.</span> <span class="nlm-surname">Arnold</span></span>, <span class="highwire-citation-author" data-delta="8"><span class="nlm-given-names">U.</span> <span class="nlm-surname">Fischer</span></span>, <span class="highwire-citation-author" data-delta="9"><span class="nlm-given-names">P.</span> <span class="nlm-surname">Mordasini</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-oa-ind highwire-cite-metadata"><i class="highwire-oa-indicator"></i> </span><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Oct 2018, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">39 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(10) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1848-1853; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A5759 </span></div>
  
  
  
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    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">J.</span> <span class="nlm-surname">Kaesmacher</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">J.</span> <span class="nlm-surname">Gralla</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">P.J.</span> <span class="nlm-surname">Mosimann</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">F.</span> <span class="nlm-surname">Zibold</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">M.R.</span> <span class="nlm-surname">Heldner</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">E.</span> <span class="nlm-surname">Piechowiak</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">T.</span> <span class="nlm-surname">Dobrocky</span></span>, <span class="highwire-citation-author" data-delta="7"><span class="nlm-given-names">M.</span> <span class="nlm-surname">Arnold</span></span>, <span class="highwire-citation-author" data-delta="8"><span class="nlm-given-names">U.</span> <span class="nlm-surname">Fischer</span></span>, <span class="highwire-citation-author" data-delta="9"><span class="nlm-given-names">P.</span> <span class="nlm-surname">Mordasini</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-oa-ind highwire-cite-metadata"><i class="highwire-oa-indicator"></i> </span><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Oct 2018, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">39 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(10) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1848-1853; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A5759 </span></div>
  
  
  
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