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<meta name="DC.Title" content="Leukoaraiosis May Confound the Interpretation of CT Perfusion in Patients Treated with Mechanical Thrombectomy for Acute Ischemic Stroke" />
<meta name="DC.Identifier" content="10.3174/ajnr.A6139" />
<meta name="DC.Date" content="2019-08-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
<meta name="DC.Rights" content="© 2019 by American Journal of Neuroradiology. Indicates open access to non-subscribers at www.ajnr.org" />
<meta name="DC.AccessRights" content="open-access" />
<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Leukoaraiosis frequently coexists in patients with acute stroke. We studied whether leukoaraiosis could confound the interpretation of CTP findings in patients treated with mechanical thrombectomy.

MATERIALS AND METHODS: We analyzed 236 patients with stroke treated with mechanical thrombectomy and studied with CTP, of whom 127 (53.8%) achieved complete reperfusion. Periventricular white matter hyperintensities on MR imaging and hypodensities on NCCT were assessed through the Fazekas score. CTP-predicted nonviable tissue was defined as relative CBF &lt;30%, and final infarct volume was quantified in DWI. We estimated mean MTT, CBV, and CBF in the asymptomatic hemisphere. In patients achieving complete reperfusion, we assessed the accuracy of nonviable tissue to predict final infarct volume using the intraclass correlation coefficient across periventricular hyperintensity/hypodensity Fazekas scores and variable relative CBF cutoffs.

RESULTS: MTT was longer (Spearman ρ = 0.279, P &lt; .001) and CBF was lower (ρ = −0.263, P &lt; .001) as the periventricular hyperintensity Fazekas score increased, while CBV was similar across groups (ρ = −0.043, P = .513). In the subgroup of patients achieving complete reperfusion, nonviable tissue–final infarct volume reliability was excellent in patients with periventricular hyperintensity Fazekas score grade 0 (intraclass correlation coefficient, 0.900; 95% CI, 0.805–0.950), fair in patients with periventricular hyperintensity Fazekas scores 1 (intraclass correlation coefficient, 0.569; 95% CI, 0.327–0.741) and 2 (intraclass correlation coefficient, 0.444; 95% CI, 0.165–0.657), and poor in patients with periventricular hyperintensity Fazekas score 3 (intraclass correlation coefficient, 0.310; 95% CI, −0.359–0.769). The most accurate cutoffs were relative CBF &lt;30% for periventricular hyperintensity Fazekas score grades 0 and 1, relative CBF &lt;25% for periventricular hyperintensity Fazekas score 2, and relative CBF &lt;20% for periventricular hyperintensity Fazekas score 3. The reliability analysis according to periventricular hypodensity Fazekas score grades on NCCT was similar to that in follow-up MR imaging.

CONCLUSIONS: In patients with stroke, the presence of leukoaraiosis confounds the interpretation of CTP despite proper adjustment of CBF thresholds.

FIV
:   final infarct volume
ICC
:   intraclass correlation coefficient
IQR
:   interquartile range
MT
:   mechanical thrombectomy
NVT
:   nonviable tissue
PVH
:   periventricular hyperintensity/hypodensity Fazekas score
rCBF
:   relative CBF" />
<meta name="DC.Contributor" content="S. Rudilosso" />
<meta name="DC.Contributor" content="C. Laredo" />
<meta name="DC.Contributor" content="C. Vivancos" />
<meta name="DC.Contributor" content="X. Urra" />
<meta name="DC.Contributor" content="L. Llull" />
<meta name="DC.Contributor" content="A. Renú" />
<meta name="DC.Contributor" content="V. Obach" />
<meta name="DC.Contributor" content="Y. Zhao" />
<meta name="DC.Contributor" content="J.L. Moreno" />
<meta name="DC.Contributor" content="A. Lopez-Rueda" />
<meta name="DC.Contributor" content="S. Amaro" />
<meta name="DC.Contributor" content="Á. Chamorro" />
<meta name="article:published_time" content="2019-08-01" />
<meta name="article:section" content="Adult Brain" />
<meta name="citation_title" content="Leukoaraiosis May Confound the Interpretation of CT Perfusion in Patients Treated with Mechanical Thrombectomy for Acute Ischemic Stroke" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;Leukoaraiosis frequently coexists in patients with acute stroke. We studied whether leukoaraiosis could confound the interpretation of CTP findings in patients treated with mechanical thrombectomy.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;We analyzed 236 patients with stroke treated with mechanical thrombectomy and studied with CTP, of whom 127 (53.8%) achieved complete reperfusion. Periventricular white matter hyperintensities on MR imaging and hypodensities on NCCT were assessed through the Fazekas score. CTP-predicted nonviable tissue was defined as relative CBF &amp;lt;30%, and final infarct volume was quantified in DWI. We estimated mean MTT, CBV, and CBF in the asymptomatic hemisphere. In patients achieving complete reperfusion, we assessed the accuracy of nonviable tissue to predict final infarct volume using the intraclass correlation coefficient across periventricular hyperintensity/hypodensity Fazekas scores and variable relative CBF cutoffs.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;MTT was longer (Spearman ρ = 0.279, &lt;i&gt;P&lt;/i&gt; &amp;lt; .001) and CBF was lower (ρ = −0.263, &lt;i&gt;P&lt;/i&gt; &amp;lt; .001) as the periventricular hyperintensity Fazekas score increased, while CBV was similar across groups (ρ = −0.043, &lt;i&gt;P&lt;/i&gt; = .513). In the subgroup of patients achieving complete reperfusion, nonviable tissue–final infarct volume reliability was excellent in patients with periventricular hyperintensity Fazekas score grade 0 (intraclass correlation coefficient, 0.900; 95% CI, 0.805–0.950), fair in patients with periventricular hyperintensity Fazekas scores 1 (intraclass correlation coefficient, 0.569; 95% CI, 0.327–0.741) and 2 (intraclass correlation coefficient, 0.444; 95% CI, 0.165–0.657), and poor in patients with periventricular hyperintensity Fazekas score 3 (intraclass correlation coefficient, 0.310; 95% CI, −0.359–0.769). The most accurate cutoffs were relative CBF &amp;lt;30% for periventricular hyperintensity Fazekas score grades 0 and 1, relative CBF &amp;lt;25% for periventricular hyperintensity Fazekas score 2, and relative CBF &amp;lt;20% for periventricular hyperintensity Fazekas score 3. The reliability analysis according to periventricular hypodensity Fazekas score grades on NCCT was similar to that in follow-up MR imaging.&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;In patients with stroke, the presence of leukoaraiosis confounds the interpretation of CTP despite proper adjustment of CBF thresholds.&lt;/p&gt;" />
<meta name="citation_journal_title" content="American Journal of Neuroradiology" />
<meta name="citation_publisher" content="American Journal of Neuroradiology" />
<meta name="citation_publication_date" content="2019/08/01" />
<meta name="citation_mjid" content="ajnr;40/8/1323" />
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<meta name="citation_issn" content="0195-6108" />
<meta name="citation_issn" content="1936-959X" />
<meta name="citation_doi" content="10.3174/ajnr.A6139" />
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<meta name="citation_volume" content="40" />
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<meta name="citation_firstpage" content="1323" />
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<meta name="citation_author" content="S. Rudilosso" />
<meta name="citation_author_institution" content="aFrom the Department of Neuroscience (S.R., C.L., X.U., L.L., A.R., V.O., Y.Z., S.A., Á.C.)., Comprehensive Stroke Center, Hospital Clinic, University of Barcelona and August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain" />
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<meta name="citation_author" content="C. Laredo" />
<meta name="citation_author_institution" content="aFrom the Department of Neuroscience (S.R., C.L., X.U., L.L., A.R., V.O., Y.Z., S.A., Á.C.)., Comprehensive Stroke Center, Hospital Clinic, University of Barcelona and August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain" />
<meta name="citation_author_orcid" content="https://orcid.org/0000-0002-4626-6360" />
<meta name="citation_author" content="C. Vivancos" />
<meta name="citation_author_institution" content="bNeurosurgery Service (C.V.), Universitary Hospital La Paz, Madrid, Spain" />
<meta name="citation_author_orcid" content="https://orcid.org/0000-0002-6230-9287" />
<meta name="citation_author" content="X. Urra" />
<meta name="citation_author_institution" content="aFrom the Department of Neuroscience (S.R., C.L., X.U., L.L., A.R., V.O., Y.Z., S.A., Á.C.)., Comprehensive Stroke Center, Hospital Clinic, University of Barcelona and August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain" />
<meta name="citation_author_orcid" content="https://orcid.org/0000-0002-4763-5252" />
<meta name="citation_author" content="L. Llull" />
<meta name="citation_author_institution" content="aFrom the Department of Neuroscience (S.R., C.L., X.U., L.L., A.R., V.O., Y.Z., S.A., Á.C.)., Comprehensive Stroke Center, Hospital Clinic, University of Barcelona and August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain" />
<meta name="citation_author_orcid" content="https://orcid.org/0000-0001-6897-2277" />
<meta name="citation_author" content="A. Renú" />
<meta name="citation_author_institution" content="aFrom the Department of Neuroscience (S.R., C.L., X.U., L.L., A.R., V.O., Y.Z., S.A., Á.C.)., Comprehensive Stroke Center, Hospital Clinic, University of Barcelona and August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain" />
<meta name="citation_author_orcid" content="https://orcid.org/0000-0001-9169-6856" />
<meta name="citation_author" content="V. Obach" />
<meta name="citation_author_institution" content="aFrom the Department of Neuroscience (S.R., C.L., X.U., L.L., A.R., V.O., Y.Z., S.A., Á.C.)., Comprehensive Stroke Center, Hospital Clinic, University of Barcelona and August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain" />
<meta name="citation_author_orcid" content="https://orcid.org/0000-0002-0518-1053" />
<meta name="citation_author" content="Y. Zhao" />
<meta name="citation_author_institution" content="aFrom the Department of Neuroscience (S.R., C.L., X.U., L.L., A.R., V.O., Y.Z., S.A., Á.C.)., Comprehensive Stroke Center, Hospital Clinic, University of Barcelona and August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain" />
<meta name="citation_author_orcid" content="https://orcid.org/0000-0002-6981-1536" />
<meta name="citation_author" content="J.L. Moreno" />
<meta name="citation_author_institution" content="dDepartment of Radiology (J.L.M., A.L.-R.), Hospital Clínic, University of Barcelona, Barcelona, Spain." />
<meta name="citation_author_orcid" content="https://orcid.org/0000-0002-0750-2797" />
<meta name="citation_author" content="A. Lopez-Rueda" />
<meta name="citation_author_institution" content="dDepartment of Radiology (J.L.M., A.L.-R.), Hospital Clínic, University of Barcelona, Barcelona, Spain." />
<meta name="citation_author_orcid" content="https://orcid.org/0000-0001-7914-9948" />
<meta name="citation_author" content="S. Amaro" />
<meta name="citation_author_institution" content="aFrom the Department of Neuroscience (S.R., C.L., X.U., L.L., A.R., V.O., Y.Z., S.A., Á.C.)., Comprehensive Stroke Center, Hospital Clinic, University of Barcelona and August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain" />
<meta name="citation_author_orcid" content="https://orcid.org/0000-0001-6838-6390" />
<meta name="citation_author" content="Á. Chamorro" />
<meta name="citation_author_institution" content="aFrom the Department of Neuroscience (S.R., C.L., X.U., L.L., A.R., V.O., Y.Z., S.A., Á.C.)., Comprehensive Stroke Center, Hospital Clinic, University of Barcelona and August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain" />
<meta name="citation_author_institution" content="cMedicine Department (Á.C.), School of Medicine, University of Barcelona, Barcelona, Spain" />
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<meta name="twitter:title" content="Leukoaraiosis May Confound the Interpretation of CT Perfusion in Patients Treated with Mechanical Thrombectomy for Acute Ischemic Stroke" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Leukoaraiosis frequently coexists in patients with acute stroke. We studied whether leukoaraiosis could confound the interpretation of CTP findings in patients treated with mechanical thrombectomy.

MATERIALS AND METHODS: We analyzed 236 patients with stroke treated with mechanical thrombectomy and studied with CTP, of whom 127 (53.8%) achieved complete reperfusion. Periventricular white matter hyperintensities on MR imaging and hypodensities on NCCT were assessed through the Fazekas score. CTP-predicted nonviable tissue was defined as relative CBF &lt;30%, and final infarct volume was quantified in DWI. We estimated mean MTT, CBV, and CBF in the asymptomatic hemisphere. In patients achieving complete reperfusion, we assessed the accuracy of nonviable tissue to predict final infarct volume using the intraclass correlation coefficient across periventricular hyperintensity/hypodensity Fazekas scores and variable relative CBF cutoffs.

RESULTS: MTT was longer (Spearman ρ = 0.279, P &lt; .001) and CBF was lower (ρ = −0.263, P &lt; .001) as the periventricular hyperintensity Fazekas score increased, while CBV was similar across groups (ρ = −0.043, P = .513). In the subgroup of patients achieving complete reperfusion, nonviable tissue–final infarct volume reliability was excellent in patients with periventricular hyperintensity Fazekas score grade 0 (intraclass correlation coefficient, 0.900; 95% CI, 0.805–0.950), fair in patients with periventricular hyperintensity Fazekas scores 1 (intraclass correlation coefficient, 0.569; 95% CI, 0.327–0.741) and 2 (intraclass correlation coefficient, 0.444; 95% CI, 0.165–0.657), and poor in patients with periventricular hyperintensity Fazekas score 3 (intraclass correlation coefficient, 0.310; 95% CI, −0.359–0.769). The most accurate cutoffs were relative CBF &lt;30% for periventricular hyperintensity Fazekas score grades 0 and 1, relative CBF &lt;25% for periventricular hyperintensity Fazekas score 2, and relative CBF &lt;20% for periventricular hyperintensity Fazekas score 3. The reliability analysis according to periventricular hypodensity Fazekas score grades on NCCT was similar to that in follow-up MR imaging.

CONCLUSIONS: In patients with stroke, the presence of leukoaraiosis confounds the interpretation of CTP despite proper adjustment of CBF thresholds.

FIV
:   final infarct volume
ICC
:   intraclass correlation coefficient
IQR
:   interquartile range
MT
:   mechanical thrombectomy
NVT
:   nonviable tissue
PVH
:   periventricular hyperintensity/hypodensity Fazekas score
rCBF
:   relative CBF" />
<meta name="og-title" property="og:title" content="Leukoaraiosis May Confound the Interpretation of CT Perfusion in Patients Treated with Mechanical Thrombectomy for Acute Ischemic Stroke" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/40/8/1323" />
<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: Leukoaraiosis frequently coexists in patients with acute stroke. We studied whether leukoaraiosis could confound the interpretation of CTP findings in patients treated with mechanical thrombectomy.

MATERIALS AND METHODS: We analyzed 236 patients with stroke treated with mechanical thrombectomy and studied with CTP, of whom 127 (53.8%) achieved complete reperfusion. Periventricular white matter hyperintensities on MR imaging and hypodensities on NCCT were assessed through the Fazekas score. CTP-predicted nonviable tissue was defined as relative CBF &lt;30%, and final infarct volume was quantified in DWI. We estimated mean MTT, CBV, and CBF in the asymptomatic hemisphere. In patients achieving complete reperfusion, we assessed the accuracy of nonviable tissue to predict final infarct volume using the intraclass correlation coefficient across periventricular hyperintensity/hypodensity Fazekas scores and variable relative CBF cutoffs.

RESULTS: MTT was longer (Spearman ρ = 0.279, P &lt; .001) and CBF was lower (ρ = −0.263, P &lt; .001) as the periventricular hyperintensity Fazekas score increased, while CBV was similar across groups (ρ = −0.043, P = .513). In the subgroup of patients achieving complete reperfusion, nonviable tissue–final infarct volume reliability was excellent in patients with periventricular hyperintensity Fazekas score grade 0 (intraclass correlation coefficient, 0.900; 95% CI, 0.805–0.950), fair in patients with periventricular hyperintensity Fazekas scores 1 (intraclass correlation coefficient, 0.569; 95% CI, 0.327–0.741) and 2 (intraclass correlation coefficient, 0.444; 95% CI, 0.165–0.657), and poor in patients with periventricular hyperintensity Fazekas score 3 (intraclass correlation coefficient, 0.310; 95% CI, −0.359–0.769). The most accurate cutoffs were relative CBF &lt;30% for periventricular hyperintensity Fazekas score grades 0 and 1, relative CBF &lt;25% for periventricular hyperintensity Fazekas score 2, and relative CBF &lt;20% for periventricular hyperintensity Fazekas score 3. The reliability analysis according to periventricular hypodensity Fazekas score grades on NCCT was similar to that in follow-up MR imaging.

CONCLUSIONS: In patients with stroke, the presence of leukoaraiosis confounds the interpretation of CTP despite proper adjustment of CBF thresholds.

FIV
:   final infarct volume
ICC
:   intraclass correlation coefficient
IQR
:   interquartile range
MT
:   mechanical thrombectomy
NVT
:   nonviable tissue
PVH
:   periventricular hyperintensity/hypodensity Fazekas score
rCBF
:   relative CBF" />
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    <div class="highwire-article-citation highwire-citation-type-highwire-article node69523--5" data-node-nid="69523" id="top-node-69523--6869517289" data-pisa="ajnr;40/8/1323" data-pisa-master="ajnr;ajnr.A6139" data-apath="/ajnr/40/8/1323.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">Adult Brain</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">Leukoaraiosis May Confound the Interpretation of CT Perfusion in Patients Treated with Mechanical Thrombectomy for Acute Ischemic Stroke</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">S. Rudilosso</span>, <span class="highwire-citation-author" data-delta="1">C. Laredo</span>, <span class="highwire-citation-author" data-delta="2">C. Vivancos</span>, <span class="highwire-citation-author" data-delta="3">X. Urra</span>, <span class="highwire-citation-author" data-delta="4">L. Llull</span>, <span class="highwire-citation-author" data-delta="5">A. Renú</span>, <span class="highwire-citation-author" data-delta="6">V. Obach</span>, <span class="highwire-citation-author" data-delta="7">Y. Zhao</span>, <span class="highwire-citation-author" data-delta="8">J.L. Moreno</span>, <span class="highwire-citation-author" data-delta="9">A. Lopez-Rueda</span>, <span class="highwire-citation-author" data-delta="10">S. Amaro</span> and <span class="highwire-citation-author" data-delta="11">Á. Chamorro</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">August 2019,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">40 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(8) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1323-1329; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A6139 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-69523--6869517289" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">S. Rudilosso </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Neuroscience (S.R., C.L., X.U., L.L., A.R., V.O., Y.Z., S.A., Á.C.)., Comprehensive Stroke Center, Hospital Clinic, University of Barcelona and August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain</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=S.%2BRudilosso%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=Rudilosso%20S&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%3AS.%2BRudilosso%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/0000-0002-8775-6884" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for S. Rudilosso</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">C. Laredo </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Neuroscience (S.R., C.L., X.U., L.L., A.R., V.O., Y.Z., S.A., Á.C.)., Comprehensive Stroke Center, Hospital Clinic, University of Barcelona and August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain</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=C.%2BLaredo%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=Laredo%20C&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%3AC.%2BLaredo%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/0000-0002-4626-6360" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for C. Laredo</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">C. Vivancos </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Neurosurgery Service (C.V.), Universitary Hospital La Paz, Madrid, Spain</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=C.%2BVivancos%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=Vivancos%20C&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%3AC.%2BVivancos%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/0000-0002-6230-9287" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for C. Vivancos</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">X. Urra </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Neuroscience (S.R., C.L., X.U., L.L., A.R., V.O., Y.Z., S.A., Á.C.)., Comprehensive Stroke Center, Hospital Clinic, University of Barcelona and August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain</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=X.%2BUrra%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=Urra%20X&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%3AX.%2BUrra%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/0000-0002-4763-5252" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for X. Urra</a></li></ul></div><div class="author-tooltip-4"><div class="author-tooltip-name">L. Llull </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Neuroscience (S.R., C.L., X.U., L.L., A.R., V.O., Y.Z., S.A., Á.C.)., Comprehensive Stroke Center, Hospital Clinic, University of Barcelona and August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain</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=L.%2BLlull%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=Llull%20L&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%3AL.%2BLlull%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/0000-0001-6897-2277" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for L. Llull</a></li></ul></div><div class="author-tooltip-5"><div class="author-tooltip-name">A. Renú </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Neuroscience (S.R., C.L., X.U., L.L., A.R., V.O., Y.Z., S.A., Á.C.)., Comprehensive Stroke Center, Hospital Clinic, University of Barcelona and August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain</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=A.%2BRen%C3%BA%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=Ren%C3%BA%20A&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%3AA.%2BRen%25C3%25BA%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/0000-0001-9169-6856" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for A. Renú</a></li></ul></div><div class="author-tooltip-6"><div class="author-tooltip-name">V. Obach </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Neuroscience (S.R., C.L., X.U., L.L., A.R., V.O., Y.Z., S.A., Á.C.)., Comprehensive Stroke Center, Hospital Clinic, University of Barcelona and August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain</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=V.%2BObach%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=Obach%20V&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%3AV.%2BObach%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/0000-0002-0518-1053" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for V. Obach</a></li></ul></div><div class="author-tooltip-7"><div class="author-tooltip-name">Y. Zhao </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Neuroscience (S.R., C.L., X.U., L.L., A.R., V.O., Y.Z., S.A., Á.C.)., Comprehensive Stroke Center, Hospital Clinic, University of Barcelona and August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain</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=Y.%2BZhao%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=Zhao%20Y&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%3AY.%2BZhao%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/0000-0002-6981-1536" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for Y. Zhao</a></li></ul></div><div class="author-tooltip-8"><div class="author-tooltip-name">J.L. Moreno </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>d</span>Department of Radiology (J.L.M., A.L.-R.), Hospital Clínic, University of Barcelona, Barcelona, Spain.</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.L.%2BMoreno%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=Moreno%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.L.%2BMoreno%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/0000-0002-0750-2797" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for J.L. Moreno</a></li></ul></div><div class="author-tooltip-9"><div class="author-tooltip-name">A. Lopez-Rueda </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>d</span>Department of Radiology (J.L.M., A.L.-R.), Hospital Clínic, University of Barcelona, Barcelona, Spain.</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=A.%2BLopez-Rueda%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=Lopez-Rueda%20A&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%3AA.%2BLopez-Rueda%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/0000-0001-7914-9948" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for A. Lopez-Rueda</a></li></ul></div><div class="author-tooltip-10"><div class="author-tooltip-name">S. Amaro </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Neuroscience (S.R., C.L., X.U., L.L., A.R., V.O., Y.Z., S.A., Á.C.)., Comprehensive Stroke Center, Hospital Clinic, University of Barcelona and August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain</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=S.%2BAmaro%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=Amaro%20S&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%3AS.%2BAmaro%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/0000-0001-6838-6390" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for S. Amaro</a></li></ul></div><div class="author-tooltip-11"><div class="author-tooltip-name">Á. Chamorro </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Neuroscience (S.R., C.L., X.U., L.L., A.R., V.O., Y.Z., S.A., Á.C.)., Comprehensive Stroke Center, Hospital Clinic, University of Barcelona and August Pi i Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain</div><div class='author-affiliation'><span class='nlm-sup'>c</span>Medicine Department (Á.C.), School of Medicine, University of Barcelona, Barcelona, Spain</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=%C3%81.%2BChamorro%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=Chamorro%20%C3%81&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%3A%25C3%2581.%2BChamorro%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/0000-0003-0493-5340" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for Á. 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      <div class="highwire-cite-title">Leukoaraiosis May Confound the Interpretation of CT Perfusion in Patients Treated with Mechanical Thrombectomy for Acute Ischemic Stroke</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">S.</span> <span class="nlm-surname">Rudilosso</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">C.</span> <span class="nlm-surname">Laredo</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">C.</span> <span class="nlm-surname">Vivancos</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">X.</span> <span class="nlm-surname">Urra</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">L.</span> <span class="nlm-surname">Llull</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">A.</span> <span class="nlm-surname">Renú</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">V.</span> <span class="nlm-surname">Obach</span></span>, <span class="highwire-citation-author" data-delta="7"><span class="nlm-given-names">Y.</span> <span class="nlm-surname">Zhao</span></span>, <span class="highwire-citation-author" data-delta="8"><span class="nlm-given-names">J.L.</span> <span class="nlm-surname">Moreno</span></span>, <span class="highwire-citation-author" data-delta="9"><span class="nlm-given-names">A.</span> <span class="nlm-surname">Lopez-Rueda</span></span>, <span class="highwire-citation-author" data-delta="10"><span class="nlm-given-names">S.</span> <span class="nlm-surname">Amaro</span></span>, <span class="highwire-citation-author" data-delta="11"><span class="nlm-given-names">Á.</span> <span class="nlm-surname">Chamorro</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">Aug 2019, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">40 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(8) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1323-1329; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A6139 </span></div>
  
  
  
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      <div class="highwire-cite-title">Leukoaraiosis May Confound the Interpretation of CT Perfusion in Patients Treated with Mechanical Thrombectomy for Acute Ischemic Stroke</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">S.</span> <span class="nlm-surname">Rudilosso</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">C.</span> <span class="nlm-surname">Laredo</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">C.</span> <span class="nlm-surname">Vivancos</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">X.</span> <span class="nlm-surname">Urra</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">L.</span> <span class="nlm-surname">Llull</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">A.</span> <span class="nlm-surname">Renú</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">V.</span> <span class="nlm-surname">Obach</span></span>, <span class="highwire-citation-author" data-delta="7"><span class="nlm-given-names">Y.</span> <span class="nlm-surname">Zhao</span></span>, <span class="highwire-citation-author" data-delta="8"><span class="nlm-given-names">J.L.</span> <span class="nlm-surname">Moreno</span></span>, <span class="highwire-citation-author" data-delta="9"><span class="nlm-given-names">A.</span> <span class="nlm-surname">Lopez-Rueda</span></span>, <span class="highwire-citation-author" data-delta="10"><span class="nlm-given-names">S.</span> <span class="nlm-surname">Amaro</span></span>, <span class="highwire-citation-author" data-delta="11"><span class="nlm-given-names">Á.</span> <span class="nlm-surname">Chamorro</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">Aug 2019, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">40 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(8) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1323-1329; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A6139 </span></div>
  
  
  
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