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<meta name="DC.Title" content="Optimal Endovascular Therapy Technique for Isolated Intracranial Atherothrombotic Stroke-Related Large-Vessel Occlusion in the Acute-to-Subacute Stage" />
<meta name="DC.Identifier" content="10.3174/ajnr.A8399" />
<meta name="DC.Date" content="2024-11-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
<meta name="DC.Rights" content="© 2024 by American Journal of Neuroradiology" />
<meta name="DC.AccessRights" content="restricted" />
<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Reocclusion after treatment is a concern in endovascular therapy for isolated intracranial atherothrombotic stroke-related large-vessel occlusion (AT-LVO). However, the optimal endovascular therapy technique for AT-LVO has not yet been investigated. This study evaluated the optimal endovascular therapy technique for AT-LVO in a real-world setting.

MATERIALS AND METHODS: We conducted a historical, multicenter registry study at 51 centers that enrolled patients with AT-LVO. We divided the patients into 3 groups based on the endovascular therapy technique: mechanical thrombectomy alone, percutaneous transluminal angioplasty (PTA), and stent deployment. Mechanical thrombectomy alone was classified into the mechanical thrombectomy-only group; PTA and mechanical thrombectomy–PTA, into the PTA group; and mechanical thrombectomy–stent deployment, mechanical thrombectomy–PTA–stent deployment, PTA–stent deployment, and stent deployment–only into the stent group. The primary outcome was incidence of reocclusion of the treated vessels within 90 days of endovascular therapy completion.

RESULTS: We enrolled 770 patients and analyzed 509 patients. The rates in the mechanical thrombectomy-only, PTA, and stent deployment groups were 40.7%, 44.4%, and 14.9%, respectively. Incidence rate of residual stenosis &gt;70% of final angiography was significantly higher in the mechanical thrombectomy-only group than in the PTA and stent deployment groups (mechanical thrombectomy-only versus PTA versus stent deployment: 34.5% versus 26.3% versus 13.2%, P = .002). Reocclusion rate was significantly lower in the PTA group than in the mechanical thrombectomy-only group (adjusted hazard ratio, 0.48; 95% CI, 0.29–0.80). Of the patients, 83.5% experienced reocclusion within 10 days after endovascular therapy. Alarmingly, a substantial subset (approximately 62.0%) of patients experienced reocclusion within 2 days of endovascular therapy. Incidence of mRS scores of 0–2 ninety days after endovascular therapy was not significantly different among the 3 groups. Incidences of symptomatic intracranial hemorrhage, any other intracranial hemorrhage, and death were not significantly different.

CONCLUSIONS: Incidence rate of reocclusion was significantly lower in the PTA group than in the mechanical thrombectomy-only group. We found no meaningful difference in reocclusion rates between the stent deployment and mechanical thrombectomy-only groups. In Japan, glycoprotein IIb/IIIa inhibitors are not reimbursed. Therefore, PTA might be the preferred choice for AT-LVOs due to the higher reocclusion risk with mechanical thrombectomy-only. Reocclusion was likely to occur within 10 days, particularly within 2 days post-endovascular therapy.

AT-LVO
:   atherothrombotic stroke-related large-vessel occlusion
DAPT
:   dual antiplatelet therapy
EVT
:   endovascular treatment
GP
:   glycoprotein
HR
:   hazard ratio
ICH
:   intracranial hemorrhage
LVO
:   large-vessel occlusion
MT
:   mechanical thrombectomy
PTA
:   percutaneous transluminal angioplasty
Stent
:   stent deployment
TAPT
:   triple antiplatelet therapy" />
<meta name="DC.Contributor" content="Mikiya Beppu" />
<meta name="DC.Contributor" content="Kazutaka Uchida" />
<meta name="DC.Contributor" content="Nobuyuki Sakai" />
<meta name="DC.Contributor" content="Hiroshi Yamagami" />
<meta name="DC.Contributor" content="Kazunori Toyoda" />
<meta name="DC.Contributor" content="Yuji Matsumaru" />
<meta name="DC.Contributor" content="Yasushi Matsumoto" />
<meta name="DC.Contributor" content="Kenichi Todo" />
<meta name="DC.Contributor" content="Mikito Hayakawa" />
<meta name="DC.Contributor" content="Seigo Shindo" />
<meta name="DC.Contributor" content="Shinzo Ota" />
<meta name="DC.Contributor" content="Masafumi Morimoto" />
<meta name="DC.Contributor" content="Masataka Takeuchi" />
<meta name="DC.Contributor" content="Hirotoshi Imamura" />
<meta name="DC.Contributor" content="Hiroyuki Ikeda" />
<meta name="DC.Contributor" content="Kanta Tanaka" />
<meta name="DC.Contributor" content="Hideyuki Ishihara" />
<meta name="DC.Contributor" content="Hiroto Kakita" />
<meta name="DC.Contributor" content="Takanori Sano" />
<meta name="DC.Contributor" content="Hayato Araki" />
<meta name="DC.Contributor" content="Tatsufumi Nomura" />
<meta name="DC.Contributor" content="Fumihiro Sakakibara" />
<meta name="DC.Contributor" content="Manabu Shirakawa" />
<meta name="DC.Contributor" content="Shinichi Yoshimura" />
<meta name="DC.Contributor" content="for the RESCUE AT-LVO Investigators" />
<meta name="article:published_time" content="2024-11-01" />
<meta name="article:section" content="Neurointervention" />
<meta name="citation_title" content="Optimal Endovascular Therapy Technique for Isolated Intracranial Atherothrombotic Stroke-Related Large-Vessel Occlusion in the Acute-to-Subacute Stage" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;Reocclusion after treatment is a concern in endovascular therapy for isolated intracranial atherothrombotic stroke-related large-vessel occlusion (AT-LVO). However, the optimal endovascular therapy technique for AT-LVO has not yet been investigated. This study evaluated the optimal endovascular therapy technique for AT-LVO in a real-world setting.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;We conducted a historical, multicenter registry study at 51 centers that enrolled patients with AT-LVO. We divided the patients into 3 groups based on the endovascular therapy technique: mechanical thrombectomy alone, percutaneous transluminal angioplasty (PTA), and stent deployment. Mechanical thrombectomy alone was classified into the mechanical thrombectomy-only group; PTA and mechanical thrombectomy–PTA, into the PTA group; and mechanical thrombectomy–stent deployment, mechanical thrombectomy–PTA–stent deployment, PTA–stent deployment, and stent deployment–only into the stent group. The primary outcome was incidence of reocclusion of the treated vessels within 90 days of endovascular therapy completion.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;We enrolled 770 patients and analyzed 509 patients. The rates in the mechanical thrombectomy-only, PTA, and stent deployment groups were 40.7%, 44.4%, and 14.9%, respectively. Incidence rate of residual stenosis &amp;gt;70% of final angiography was significantly higher in the mechanical thrombectomy-only group than in the PTA and stent deployment groups (mechanical thrombectomy-only versus PTA versus stent deployment: 34.5% versus 26.3% versus 13.2%, &lt;i&gt;P&lt;/i&gt; = .002). Reocclusion rate was significantly lower in the PTA group than in the mechanical thrombectomy-only group (adjusted hazard ratio, 0.48; 95% CI, 0.29–0.80). Of the patients, 83.5% experienced reocclusion within 10 days after endovascular therapy. Alarmingly, a substantial subset (approximately 62.0%) of patients experienced reocclusion within 2 days of endovascular therapy. Incidence of mRS scores of 0–2 ninety days after endovascular therapy was not significantly different among the 3 groups. Incidences of symptomatic intracranial hemorrhage, any other intracranial hemorrhage, and death were not significantly different.&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;Incidence rate of reocclusion was significantly lower in the PTA group than in the mechanical thrombectomy-only group. We found no meaningful difference in reocclusion rates between the stent deployment and mechanical thrombectomy-only groups. In Japan, glycoprotein IIb/IIIa inhibitors are not reimbursed. Therefore, PTA might be the preferred choice for AT-LVOs due to the higher reocclusion risk with mechanical thrombectomy-only. Reocclusion was likely to occur within 10 days, particularly within 2 days post-endovascular therapy.&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="2024/11/01" />
<meta name="citation_mjid" content="ajnr;45/11/1692" />
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<meta name="citation_author" content="Mikiya Beppu" />
<meta name="citation_author_institution" content="aFrom the Department of Neurosurgery (M.B., K.U., F.S., M.S., S.Y.), Hyogo Medical University, Nishinomiya, Japan" />
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<meta name="citation_author" content="Kazutaka Uchida" />
<meta name="citation_author_institution" content="aFrom the Department of Neurosurgery (M.B., K.U., F.S., M.S., S.Y.), Hyogo Medical University, Nishinomiya, Japan" />
<meta name="citation_author_orcid" content="https://orcid.org/0000-0003-4780-9598" />
<meta name="citation_author" content="Nobuyuki Sakai" />
<meta name="citation_author_institution" content="bNeurovascular Research &amp; Neuroendovascular Therapy (N.S.), Kobe City Medical Center General Hospital, Kobe, Japan" />
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<meta name="citation_author" content="Hiroshi Yamagami" />
<meta name="citation_author_institution" content="cDepartment of Stroke Neurology (H.Y.), National Hospital Organization Osaka National Hospital, Osaka, Japan" />
<meta name="citation_author" content="Kazunori Toyoda" />
<meta name="citation_author_institution" content="dDepartment of Cerebrovascular Medicine (K. Toyoda., K.Tanaka), National Cerebral and Cardiovascular Center, Suita, Japan" />
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<meta name="twitter:title" content="Optimal Endovascular Therapy Technique for Isolated Intracranial Atherothrombotic Stroke-Related Large-Vessel Occlusion in the Acute-to-Subacute Stage" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Reocclusion after treatment is a concern in endovascular therapy for isolated intracranial atherothrombotic stroke-related large-vessel occlusion (AT-LVO). However, the optimal endovascular therapy technique for AT-LVO has not yet been investigated. This study evaluated the optimal endovascular therapy technique for AT-LVO in a real-world setting.

MATERIALS AND METHODS: We conducted a historical, multicenter registry study at 51 centers that enrolled patients with AT-LVO. We divided the patients into 3 groups based on the endovascular therapy technique: mechanical thrombectomy alone, percutaneous transluminal angioplasty (PTA), and stent deployment. Mechanical thrombectomy alone was classified into the mechanical thrombectomy-only group; PTA and mechanical thrombectomy–PTA, into the PTA group; and mechanical thrombectomy–stent deployment, mechanical thrombectomy–PTA–stent deployment, PTA–stent deployment, and stent deployment–only into the stent group. The primary outcome was incidence of reocclusion of the treated vessels within 90 days of endovascular therapy completion.

RESULTS: We enrolled 770 patients and analyzed 509 patients. The rates in the mechanical thrombectomy-only, PTA, and stent deployment groups were 40.7%, 44.4%, and 14.9%, respectively. Incidence rate of residual stenosis &gt;70% of final angiography was significantly higher in the mechanical thrombectomy-only group than in the PTA and stent deployment groups (mechanical thrombectomy-only versus PTA versus stent deployment: 34.5% versus 26.3% versus 13.2%, P = .002). Reocclusion rate was significantly lower in the PTA group than in the mechanical thrombectomy-only group (adjusted hazard ratio, 0.48; 95% CI, 0.29–0.80). Of the patients, 83.5% experienced reocclusion within 10 days after endovascular therapy. Alarmingly, a substantial subset (approximately 62.0%) of patients experienced reocclusion within 2 days of endovascular therapy. Incidence of mRS scores of 0–2 ninety days after endovascular therapy was not significantly different among the 3 groups. Incidences of symptomatic intracranial hemorrhage, any other intracranial hemorrhage, and death were not significantly different.

CONCLUSIONS: Incidence rate of reocclusion was significantly lower in the PTA group than in the mechanical thrombectomy-only group. We found no meaningful difference in reocclusion rates between the stent deployment and mechanical thrombectomy-only groups. In Japan, glycoprotein IIb/IIIa inhibitors are not reimbursed. Therefore, PTA might be the preferred choice for AT-LVOs due to the higher reocclusion risk with mechanical thrombectomy-only. Reocclusion was likely to occur within 10 days, particularly within 2 days post-endovascular therapy.

AT-LVO
:   atherothrombotic stroke-related large-vessel occlusion
DAPT
:   dual antiplatelet therapy
EVT
:   endovascular treatment
GP
:   glycoprotein
HR
:   hazard ratio
ICH
:   intracranial hemorrhage
LVO
:   large-vessel occlusion
MT
:   mechanical thrombectomy
PTA
:   percutaneous transluminal angioplasty
Stent
:   stent deployment
TAPT
:   triple antiplatelet therapy" />
<meta name="og-title" property="og:title" content="Optimal Endovascular Therapy Technique for Isolated Intracranial Atherothrombotic Stroke-Related Large-Vessel Occlusion in the Acute-to-Subacute Stage" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/45/11/1692" />
<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: Reocclusion after treatment is a concern in endovascular therapy for isolated intracranial atherothrombotic stroke-related large-vessel occlusion (AT-LVO). However, the optimal endovascular therapy technique for AT-LVO has not yet been investigated. This study evaluated the optimal endovascular therapy technique for AT-LVO in a real-world setting.

MATERIALS AND METHODS: We conducted a historical, multicenter registry study at 51 centers that enrolled patients with AT-LVO. We divided the patients into 3 groups based on the endovascular therapy technique: mechanical thrombectomy alone, percutaneous transluminal angioplasty (PTA), and stent deployment. Mechanical thrombectomy alone was classified into the mechanical thrombectomy-only group; PTA and mechanical thrombectomy–PTA, into the PTA group; and mechanical thrombectomy–stent deployment, mechanical thrombectomy–PTA–stent deployment, PTA–stent deployment, and stent deployment–only into the stent group. The primary outcome was incidence of reocclusion of the treated vessels within 90 days of endovascular therapy completion.

RESULTS: We enrolled 770 patients and analyzed 509 patients. The rates in the mechanical thrombectomy-only, PTA, and stent deployment groups were 40.7%, 44.4%, and 14.9%, respectively. Incidence rate of residual stenosis &gt;70% of final angiography was significantly higher in the mechanical thrombectomy-only group than in the PTA and stent deployment groups (mechanical thrombectomy-only versus PTA versus stent deployment: 34.5% versus 26.3% versus 13.2%, P = .002). Reocclusion rate was significantly lower in the PTA group than in the mechanical thrombectomy-only group (adjusted hazard ratio, 0.48; 95% CI, 0.29–0.80). Of the patients, 83.5% experienced reocclusion within 10 days after endovascular therapy. Alarmingly, a substantial subset (approximately 62.0%) of patients experienced reocclusion within 2 days of endovascular therapy. Incidence of mRS scores of 0–2 ninety days after endovascular therapy was not significantly different among the 3 groups. Incidences of symptomatic intracranial hemorrhage, any other intracranial hemorrhage, and death were not significantly different.

CONCLUSIONS: Incidence rate of reocclusion was significantly lower in the PTA group than in the mechanical thrombectomy-only group. We found no meaningful difference in reocclusion rates between the stent deployment and mechanical thrombectomy-only groups. In Japan, glycoprotein IIb/IIIa inhibitors are not reimbursed. Therefore, PTA might be the preferred choice for AT-LVOs due to the higher reocclusion risk with mechanical thrombectomy-only. Reocclusion was likely to occur within 10 days, particularly within 2 days post-endovascular therapy.

AT-LVO
:   atherothrombotic stroke-related large-vessel occlusion
DAPT
:   dual antiplatelet therapy
EVT
:   endovascular treatment
GP
:   glycoprotein
HR
:   hazard ratio
ICH
:   intracranial hemorrhage
LVO
:   large-vessel occlusion
MT
:   mechanical thrombectomy
PTA
:   percutaneous transluminal angioplasty
Stent
:   stent deployment
TAPT
:   triple antiplatelet therapy" />
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      <h1 class="highwire-cite-title" id="page-title">Optimal Endovascular Therapy Technique for Isolated Intracranial Atherothrombotic Stroke-Related Large-Vessel Occlusion in the Acute-to-Subacute Stage</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">Mikiya Beppu</span>, <span class="highwire-citation-author" data-delta="1">Kazutaka Uchida</span>, <span class="highwire-citation-author" data-delta="2">Nobuyuki Sakai</span>, <span class="highwire-citation-author" data-delta="3">Hiroshi Yamagami</span>, <span class="highwire-citation-author" data-delta="4">Kazunori Toyoda</span>, <span class="highwire-citation-author" data-delta="5">Yuji Matsumaru</span>, <span class="highwire-citation-author" data-delta="6">Yasushi Matsumoto</span>, <span class="highwire-citation-author" data-delta="7">Kenichi Todo</span>, <span class="highwire-citation-author" data-delta="8">Mikito Hayakawa</span>, <span class="highwire-citation-author" data-delta="9">Seigo Shindo</span>, <span class="highwire-citation-author" data-delta="10">Shinzo Ota</span>, <span class="highwire-citation-author" data-delta="11">Masafumi Morimoto</span>, <span class="highwire-citation-author" data-delta="12">Masataka Takeuchi</span>, <span class="highwire-citation-author" data-delta="13">Hirotoshi Imamura</span>, <span class="highwire-citation-author" data-delta="14">Hiroyuki Ikeda</span>, <span class="highwire-citation-author" data-delta="15">Kanta Tanaka</span>, <span class="highwire-citation-author" data-delta="16">Hideyuki Ishihara</span>, <span class="highwire-citation-author" data-delta="17">Hiroto Kakita</span>, <span class="highwire-citation-author" data-delta="18">Takanori Sano</span>, <span class="highwire-citation-author" data-delta="19">Hayato Araki</span>, <span class="highwire-citation-author" data-delta="20">Tatsufumi Nomura</span>, <span class="highwire-citation-author" data-delta="21">Fumihiro Sakakibara</span>, <span class="highwire-citation-author" data-delta="22">Manabu Shirakawa</span>, <span class="highwire-citation-author" data-delta="23">Shinichi Yoshimura</span> and <span class="highwire-citation-author" data-delta="24"><span class="nlm-collab" data-hwp-id="collab-1">for the RESCUE AT-LVO Investigators</span></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">November 2024,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">45 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(11) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1692-1700; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A8399 </span></div>
  
  
  
</div>
<div id="hw-article-author-popups-top-node-111449--6620974805" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">Mikiya Beppu </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 Neurosurgery (M.B., K.U., F.S., M.S., S.Y.), Hyogo Medical University, Nishinomiya, Japan</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=Mikiya%2BBeppu%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=Beppu%20M&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li 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class="author-tooltip-3"><div class="author-tooltip-name">Hiroshi Yamagami </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>c</span>Department of Stroke Neurology (H.Y.), National Hospital Organization Osaka National Hospital, Osaka, Japan</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=Hiroshi%2BYamagami%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=Yamagami%20H&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 last"><a href="/search/author1%3AHiroshi%2BYamagami%2B" rel="nofollow" class="" 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        	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-volume highwire-cite-metadata">Vol. 45</span>, <span  class="highwire-cite-metadata-issue highwire-cite-metadata">Issue 11 </span><div  class="highwire-cite-metadata-pubdate highwire-cite-metadata">1 Nov 2024 </div></div>
      
      
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      <div class="highwire-cite-title">Endovascular Therapy for Intracranial 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">Mikiya</span> <span class="nlm-surname">Beppu</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">Kazutaka</span> <span class="nlm-surname">Uchida</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">Nobuyuki</span> <span class="nlm-surname">Sakai</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">Hiroshi</span> <span class="nlm-surname">Yamagami</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">Kazunori</span> <span class="nlm-surname">Toyoda</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">Yuji</span> <span class="nlm-surname">Matsumaru</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">Yasushi</span> <span class="nlm-surname">Matsumoto</span></span>, <span class="highwire-citation-author" data-delta="7"><span class="nlm-given-names">Kenichi</span> <span class="nlm-surname">Todo</span></span>, <span class="highwire-citation-author" data-delta="8"><span class="nlm-given-names">Mikito</span> <span class="nlm-surname">Hayakawa</span></span>, <span class="highwire-citation-author" data-delta="9"><span class="nlm-given-names">Seigo</span> <span class="nlm-surname">Shindo</span></span>, <span class="highwire-citation-author" data-delta="10"><span class="nlm-given-names">Shinzo</span> <span class="nlm-surname">Ota</span></span>, <span class="highwire-citation-author" data-delta="11"><span class="nlm-given-names">Masafumi</span> <span class="nlm-surname">Morimoto</span></span>, <span class="highwire-citation-author" data-delta="12"><span class="nlm-given-names">Masataka</span> <span class="nlm-surname">Takeuchi</span></span>, <span class="highwire-citation-author" data-delta="13"><span class="nlm-given-names">Hirotoshi</span> <span class="nlm-surname">Imamura</span></span>, <span class="highwire-citation-author" data-delta="14"><span class="nlm-given-names">Hiroyuki</span> <span class="nlm-surname">Ikeda</span></span>, <span class="highwire-citation-author" data-delta="15"><span class="nlm-given-names">Kanta</span> <span class="nlm-surname">Tanaka</span></span>, <span class="highwire-citation-author" data-delta="16"><span class="nlm-given-names">Hideyuki</span> <span class="nlm-surname">Ishihara</span></span>, <span class="highwire-citation-author" data-delta="17"><span class="nlm-given-names">Hiroto</span> <span class="nlm-surname">Kakita</span></span>, <span class="highwire-citation-author" data-delta="18"><span class="nlm-given-names">Takanori</span> <span class="nlm-surname">Sano</span></span>, <span class="highwire-citation-author" data-delta="19"><span class="nlm-given-names">Hayato</span> <span class="nlm-surname">Araki</span></span>, <span class="highwire-citation-author" data-delta="20"><span class="nlm-given-names">Tatsufumi</span> <span class="nlm-surname">Nomura</span></span>, <span class="highwire-citation-author" data-delta="21"><span class="nlm-given-names">Fumihiro</span> <span class="nlm-surname">Sakakibara</span></span>, <span class="highwire-citation-author" data-delta="22"><span class="nlm-given-names">Manabu</span> <span class="nlm-surname">Shirakawa</span></span>, <span class="highwire-citation-author" data-delta="23"><span class="nlm-given-names">Shinichi</span> <span class="nlm-surname">Yoshimura</span></span>, <span class="highwire-citation-author" data-delta="24"><span class="nlm-collab" data-hwp-id="collab-1">for the RESCUE AT-LVO Investigators</span></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">Nov 2024, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">45 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(11) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1692-1700; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A8399 </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">Mikiya</span> <span class="nlm-surname">Beppu</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">Kazutaka</span> <span class="nlm-surname">Uchida</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">Nobuyuki</span> <span class="nlm-surname">Sakai</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">Hiroshi</span> <span class="nlm-surname">Yamagami</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">Kazunori</span> <span class="nlm-surname">Toyoda</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">Yuji</span> <span class="nlm-surname">Matsumaru</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">Yasushi</span> <span class="nlm-surname">Matsumoto</span></span>, <span class="highwire-citation-author" data-delta="7"><span class="nlm-given-names">Kenichi</span> <span class="nlm-surname">Todo</span></span>, <span class="highwire-citation-author" data-delta="8"><span class="nlm-given-names">Mikito</span> <span class="nlm-surname">Hayakawa</span></span>, <span class="highwire-citation-author" data-delta="9"><span class="nlm-given-names">Seigo</span> <span class="nlm-surname">Shindo</span></span>, <span class="highwire-citation-author" data-delta="10"><span class="nlm-given-names">Shinzo</span> <span class="nlm-surname">Ota</span></span>, <span class="highwire-citation-author" data-delta="11"><span class="nlm-given-names">Masafumi</span> <span class="nlm-surname">Morimoto</span></span>, <span class="highwire-citation-author" data-delta="12"><span class="nlm-given-names">Masataka</span> <span class="nlm-surname">Takeuchi</span></span>, <span class="highwire-citation-author" data-delta="13"><span class="nlm-given-names">Hirotoshi</span> <span class="nlm-surname">Imamura</span></span>, <span class="highwire-citation-author" data-delta="14"><span class="nlm-given-names">Hiroyuki</span> <span class="nlm-surname">Ikeda</span></span>, <span class="highwire-citation-author" data-delta="15"><span class="nlm-given-names">Kanta</span> <span class="nlm-surname">Tanaka</span></span>, <span class="highwire-citation-author" data-delta="16"><span class="nlm-given-names">Hideyuki</span> <span class="nlm-surname">Ishihara</span></span>, <span class="highwire-citation-author" data-delta="17"><span class="nlm-given-names">Hiroto</span> <span class="nlm-surname">Kakita</span></span>, <span class="highwire-citation-author" data-delta="18"><span class="nlm-given-names">Takanori</span> <span class="nlm-surname">Sano</span></span>, <span class="highwire-citation-author" data-delta="19"><span class="nlm-given-names">Hayato</span> <span class="nlm-surname">Araki</span></span>, <span class="highwire-citation-author" data-delta="20"><span class="nlm-given-names">Tatsufumi</span> <span class="nlm-surname">Nomura</span></span>, <span class="highwire-citation-author" data-delta="21"><span class="nlm-given-names">Fumihiro</span> <span class="nlm-surname">Sakakibara</span></span>, <span class="highwire-citation-author" data-delta="22"><span class="nlm-given-names">Manabu</span> <span class="nlm-surname">Shirakawa</span></span>, <span class="highwire-citation-author" data-delta="23"><span class="nlm-given-names">Shinichi</span> <span class="nlm-surname">Yoshimura</span></span>, <span class="highwire-citation-author" data-delta="24"><span class="nlm-collab" data-hwp-id="collab-1">for the RESCUE AT-LVO Investigators</span></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">Nov 2024, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">45 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(11) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1692-1700; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A8399 </span></div>
  
  
  
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