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<meta name="DC.Title" content="Prolonged Venous Transit on Perfusion Imaging is Associated with Longer Lengths of Stay in Acute Large Vessel Occlusions" />
<meta name="DC.Identifier" content="10.3174/ajnr.A8611" />
<meta name="DC.Date" content="2024-11-26" />
<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: Prolonged venous transit (PVT+) is a marker of venous outflow; it is defined as the presence or absence of time-to-maximum ≥10 seconds timing in either the superior sagittal sinus or torcula. This novel perfusion imaging-based metric has been associated with higher odds of mortality and lower odds of functional recovery. This study aims to assess the relationship between PVT on admission perfusion imaging and length of hospital stay in large vessel occlusion strokes successfully reperfused with mechanical thrombectomy.

MATERIALS AND METHODS: Acute ischemic stroke patients with large vessel occlusions in the anterior circulation successfully treated with thrombectomy between 01/2017 and 09/2022 were retrospectively reviewed. The primary outcome was length of stay in the hospital due to the acute stroke event. Univariable and forward stepwise multivariable linear regressions were performed for the primary outcome.

RESULTS: Of 109 patients meeting inclusion, median age was 71 (interquartile range [IQR] 62-80) years. Median hospital length of stay was significantly greater in PVT+ patients (9 [IQR 6-18] days) compared to PVT-patients (6 [IQR 4-12] days, p=0.03). In multivariable regression, PVT+ was significantly associated with length of stay, and PVT+ was associated with approximately two additional days of hospital stay compared to PVT-(p=0.03).

CONCLUSIONS: In successfully reperfused large vessel occlusion strokes, PVT+ was associated with an additional two days of hospital stay on average compared to PVT-patients, when adjusting for other clinical covariables. This simple, novel imaging metric is robust in correlating with a range of short and long term clinical outcomes.

ABBREVIATIONS: VO = venous outflow; Tmax = time-to-maximum; PVT = prolonged venous transit; AIS-LVO = large vessel occlusion ischemic stroke; SSS = superior sagittal sinus; rCBF = relative cerebral blood flow; IQR = interquartile range; VIF = variance inflation factor." />
<meta name="DC.Contributor" content="Manisha Koneru" />
<meta name="DC.Contributor" content="Janet Y. Mei" />
<meta name="DC.Contributor" content="Dhairya A. Lakhani" />
<meta name="DC.Contributor" content="Hamza A. Salim" />
<meta name="DC.Contributor" content="Mona Shahriari" />
<meta name="DC.Contributor" content="Adam A. Dmytriw" />
<meta name="DC.Contributor" content="Adrien Guenego" />
<meta name="DC.Contributor" content="Jeremy J. Heit" />
<meta name="DC.Contributor" content="Gregory W. Albers" />
<meta name="DC.Contributor" content="Dylan Wolman" />
<meta name="DC.Contributor" content="Tobias D. Faizy" />
<meta name="DC.Contributor" content="Benjamin Pulli" />
<meta name="DC.Contributor" content="Vaibhav Vagal" />
<meta name="DC.Contributor" content="Aakanksha Sriwastwa" />
<meta name="DC.Contributor" content="Yasmin Aziz" />
<meta name="DC.Contributor" content="Risheng Xu" />
<meta name="DC.Contributor" content="Hanzhang Lu" />
<meta name="DC.Contributor" content="Victor C. Urrutia" />
<meta name="DC.Contributor" content="Elisabeth B. Marsh" />
<meta name="DC.Contributor" content="Richard Leigh" />
<meta name="DC.Contributor" content="Mona Bahouth" />
<meta name="DC.Contributor" content="Rafael H. Llinas" />
<meta name="DC.Contributor" content="Kambiz Nael" />
<meta name="DC.Contributor" content="ArgyeE. Hillis" />
<meta name="DC.Contributor" content="Vivek S. Yedavalli" />
<meta name="article:published_time" content="2024-11-26" />
<meta name="article:section" content="ORIGINAL RESEARCH" />
<meta name="citation_title" content="Prolonged Venous Transit on Perfusion Imaging is Associated with Longer Lengths of Stay in Acute Large Vessel Occlusions" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;ABSTRACT&lt;/h3&gt;
&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;Prolonged venous transit (PVT+) is a marker of venous outflow; it is defined as the presence or absence of time-to-maximum ≥10 seconds timing in either the superior sagittal sinus or torcula. This novel perfusion imaging-based metric has been associated with higher odds of mortality and lower odds of functional recovery. This study aims to assess the relationship between PVT on admission perfusion imaging and length of hospital stay in large vessel occlusion strokes successfully reperfused with mechanical thrombectomy.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;Acute ischemic stroke patients with large vessel occlusions in the anterior circulation successfully treated with thrombectomy between 01/2017 and 09/2022 were retrospectively reviewed. The primary outcome was length of stay in the hospital due to the acute stroke event. Univariable and forward stepwise multivariable linear regressions were performed for the primary outcome.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;Of 109 patients meeting inclusion, median age was 71 (interquartile range [IQR] 62-80) years. Median hospital length of stay was significantly greater in PVT+ patients (9 [IQR 6-18] days) compared to PVT-patients (6 [IQR 4-12] days, p=0.03). In multivariable regression, PVT+ was significantly associated with length of stay, and PVT+ was associated with approximately two additional days of hospital stay compared to PVT-(p=0.03).&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;In successfully reperfused large vessel occlusion strokes, PVT+ was associated with an additional two days of hospital stay on average compared to PVT-patients, when adjusting for other clinical covariables. This simple, novel imaging metric is robust in correlating with a range of short and long term clinical outcomes.&lt;/p&gt;&lt;p&gt;ABBREVIATIONS: VO = venous outflow; Tmax = time-to-maximum; PVT = prolonged venous transit; AIS-LVO = large vessel occlusion ischemic stroke; SSS = superior sagittal sinus; rCBF = relative cerebral blood flow; IQR = interquartile range; VIF = variance inflation factor.&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="2024/11/26" />
<meta name="citation_mjid" content="ajnr;ajnr.A8611v1" />
<meta name="citation_id" content="ajnr.A8611v1" />
<meta name="citation_public_url" content="http://ajnr-stage2.stage.highwire.org/content/early/2024/11/26/ajnr.A8611" />
<meta name="citation_abstract_html_url" content="http://ajnr-stage2.stage.highwire.org/content/early/2024/11/26/ajnr.A8611.abstract" />
<meta name="citation_full_html_url" content="http://ajnr-stage2.stage.highwire.org/content/early/2024/11/26/ajnr.A8611.full" />
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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.A8611" />
<meta name="citation_pmid" content="39592183" />
<meta name="citation_article_type" content="Research Article" />
<meta name="citation_section" content="ORIGINAL RESEARCH" />
<meta name="citation_author" content="Manisha Koneru" />
<meta name="citation_author_institution" content="From the Department of Radiology (M.K.), Cooper Medical School of Rowan University, Camden, NJ, USA; Department of Radiology (J.Y.M., H.A.S., M.S., H.L., V.S.Y), Department of Neurosurgery (R.X.), and Department of Neurology (V.C.U., E.B.M., R.L., M.B., R.H.L, A.E.H), Johns Hopkins Hospital, Baltimore, MD, USA; Department of Radiology (D.A.L.), West Virginia University Medicine, Morgantown, WV, USA; Department of Neuroradiology (A.A.D.), Massachusetts General Hospital &amp; Harvard Medical School, Boston, MA, USA; Department of Radiology (A.G.), Universite Libre De Bruxelles Hospital, Erasme, Belgium; Department of Radiology (J.J.H., B.P.), Department of Neurology (G.W.A.), Stanford University School of Medicine, Stanford, CA, USA; Department of Radiology (D.W.), Brown University/Rhode Island Hospital, Providence, RI, USA; Department of Radiology (T.D.F.), University Medical Center Munster, Munster, Germany; Department of Radiology (V.V.), Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA; Department of Radiology (A.S.), Department of Neurology (Y.A.), University of Cincinnati, Cincinnati, OH, USA; Department of Radiology and Biomedical Imaging (K.N.), University of California San Francisco, San Francisco, CA, USA." />
<meta name="citation_author" content="Janet Y. Mei" />
<meta name="citation_author_institution" content="From the Department of Radiology (M.K.), Cooper Medical School of Rowan University, Camden, NJ, USA; Department of Radiology (J.Y.M., H.A.S., M.S., H.L., V.S.Y), Department of Neurosurgery (R.X.), and Department of Neurology (V.C.U., E.B.M., R.L., M.B., R.H.L, A.E.H), Johns Hopkins Hospital, Baltimore, MD, USA; Department of Radiology (D.A.L.), West Virginia University Medicine, Morgantown, WV, USA; Department of Neuroradiology (A.A.D.), Massachusetts General Hospital &amp; Harvard Medical School, Boston, MA, USA; Department of Radiology (A.G.), Universite Libre De Bruxelles Hospital, Erasme, Belgium; Department of Radiology (J.J.H., B.P.), Department of Neurology (G.W.A.), Stanford University School of Medicine, Stanford, CA, USA; Department of Radiology (D.W.), Brown University/Rhode Island Hospital, Providence, RI, USA; Department of Radiology (T.D.F.), University Medical Center Munster, Munster, Germany; Department of Radiology (V.V.), Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA; Department of Radiology (A.S.), Department of Neurology (Y.A.), University of Cincinnati, Cincinnati, OH, USA; Department of Radiology and Biomedical Imaging (K.N.), University of California San Francisco, San Francisco, CA, USA." />
<meta name="citation_author" content="Dhairya A. Lakhani" />
<meta name="citation_author_institution" content="From the Department of Radiology (M.K.), Cooper Medical School of Rowan University, Camden, NJ, USA; Department of Radiology (J.Y.M., H.A.S., M.S., H.L., V.S.Y), Department of Neurosurgery (R.X.), and Department of Neurology (V.C.U., E.B.M., R.L., M.B., R.H.L, A.E.H), Johns Hopkins Hospital, Baltimore, MD, USA; Department of Radiology (D.A.L.), West Virginia University Medicine, Morgantown, WV, USA; Department of Neuroradiology (A.A.D.), Massachusetts General Hospital &amp; Harvard Medical School, Boston, MA, USA; Department of Radiology (A.G.), Universite Libre De Bruxelles Hospital, Erasme, Belgium; Department of Radiology (J.J.H., B.P.), Department of Neurology (G.W.A.), Stanford University School of Medicine, Stanford, CA, USA; Department of Radiology (D.W.), Brown University/Rhode Island Hospital, Providence, RI, USA; Department of Radiology (T.D.F.), University Medical Center Munster, Munster, Germany; Department of Radiology (V.V.), Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA; Department of Radiology (A.S.), Department of Neurology (Y.A.), University of Cincinnati, Cincinnati, OH, USA; Department of Radiology and Biomedical Imaging (K.N.), University of California San Francisco, San Francisco, CA, USA." />
<meta name="citation_author" content="Hamza A. Salim" />
<meta name="citation_author_institution" content="From the Department of Radiology (M.K.), Cooper Medical School of Rowan University, Camden, NJ, USA; Department of Radiology (J.Y.M., H.A.S., M.S., H.L., V.S.Y), Department of Neurosurgery (R.X.), and Department of Neurology (V.C.U., E.B.M., R.L., M.B., R.H.L, A.E.H), Johns Hopkins Hospital, Baltimore, MD, USA; Department of Radiology (D.A.L.), West Virginia University Medicine, Morgantown, WV, USA; Department of Neuroradiology (A.A.D.), Massachusetts General Hospital &amp; Harvard Medical School, Boston, MA, USA; Department of Radiology (A.G.), Universite Libre De Bruxelles Hospital, Erasme, Belgium; Department of Radiology (J.J.H., B.P.), Department of Neurology (G.W.A.), Stanford University School of Medicine, Stanford, CA, USA; Department of Radiology (D.W.), Brown University/Rhode Island Hospital, Providence, RI, USA; Department of Radiology (T.D.F.), University Medical Center Munster, Munster, Germany; Department of Radiology (V.V.), Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA; Department of Radiology (A.S.), Department of Neurology (Y.A.), University of Cincinnati, Cincinnati, OH, USA; Department of Radiology and Biomedical Imaging (K.N.), University of California San Francisco, San Francisco, CA, USA." />
<meta name="citation_author" content="Mona Shahriari" />
<meta name="citation_author_institution" content="From the Department of Radiology (M.K.), Cooper Medical School of Rowan University, Camden, NJ, USA; Department of Radiology (J.Y.M., H.A.S., M.S., H.L., V.S.Y), Department of Neurosurgery (R.X.), and Department of Neurology (V.C.U., E.B.M., R.L., M.B., R.H.L, A.E.H), Johns Hopkins Hospital, Baltimore, MD, USA; Department of Radiology (D.A.L.), West Virginia University Medicine, Morgantown, WV, USA; Department of Neuroradiology (A.A.D.), Massachusetts General Hospital &amp; Harvard Medical School, Boston, MA, USA; Department of Radiology (A.G.), Universite Libre De Bruxelles Hospital, Erasme, Belgium; Department of Radiology (J.J.H., B.P.), Department of Neurology (G.W.A.), Stanford University School of Medicine, Stanford, CA, USA; Department of Radiology (D.W.), Brown University/Rhode Island Hospital, Providence, RI, USA; Department of Radiology (T.D.F.), University Medical Center Munster, Munster, Germany; Department of Radiology (V.V.), Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA; Department of Radiology (A.S.), Department of Neurology (Y.A.), University of Cincinnati, Cincinnati, OH, USA; Department of Radiology and Biomedical Imaging (K.N.), University of California San Francisco, San Francisco, CA, USA." />
<meta name="citation_author" content="Adam A. Dmytriw" />
<meta name="citation_author_institution" content="From the Department of Radiology (M.K.), Cooper Medical School of Rowan University, Camden, NJ, USA; Department of Radiology (J.Y.M., H.A.S., M.S., H.L., V.S.Y), Department of Neurosurgery (R.X.), and Department of Neurology (V.C.U., E.B.M., R.L., M.B., R.H.L, A.E.H), Johns Hopkins Hospital, Baltimore, MD, USA; Department of Radiology (D.A.L.), West Virginia University Medicine, Morgantown, WV, USA; Department of Neuroradiology (A.A.D.), Massachusetts General Hospital &amp; Harvard Medical School, Boston, MA, USA; Department of Radiology (A.G.), Universite Libre De Bruxelles Hospital, Erasme, Belgium; Department of Radiology (J.J.H., B.P.), Department of Neurology (G.W.A.), Stanford University School of Medicine, Stanford, CA, USA; Department of Radiology (D.W.), Brown University/Rhode Island Hospital, Providence, RI, USA; Department of Radiology (T.D.F.), University Medical Center Munster, Munster, Germany; Department of Radiology (V.V.), Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA; Department of Radiology (A.S.), Department of Neurology (Y.A.), University of Cincinnati, Cincinnati, OH, USA; Department of Radiology and Biomedical Imaging (K.N.), University of California San Francisco, San Francisco, CA, USA." />
<meta name="citation_author" content="Adrien Guenego" />
<meta name="citation_author_institution" content="From the Department of Radiology (M.K.), Cooper Medical School of Rowan University, Camden, NJ, USA; Department of Radiology (J.Y.M., H.A.S., M.S., H.L., V.S.Y), Department of Neurosurgery (R.X.), and Department of Neurology (V.C.U., E.B.M., R.L., M.B., R.H.L, A.E.H), Johns Hopkins Hospital, Baltimore, MD, USA; Department of Radiology (D.A.L.), West Virginia University Medicine, Morgantown, WV, USA; Department of Neuroradiology (A.A.D.), Massachusetts General Hospital &amp; Harvard Medical School, Boston, MA, USA; Department of Radiology (A.G.), Universite Libre De Bruxelles Hospital, Erasme, Belgium; Department of Radiology (J.J.H., B.P.), Department of Neurology (G.W.A.), Stanford University School of Medicine, Stanford, CA, USA; Department of Radiology (D.W.), Brown University/Rhode Island Hospital, Providence, RI, USA; Department of Radiology (T.D.F.), University Medical Center Munster, Munster, Germany; Department of Radiology (V.V.), Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA; Department of Radiology (A.S.), Department of Neurology (Y.A.), University of Cincinnati, Cincinnati, OH, USA; Department of Radiology and Biomedical Imaging (K.N.), University of California San Francisco, San Francisco, CA, USA." />
<meta name="citation_author" content="Jeremy J. Heit" />
<meta name="citation_author_institution" content="From the Department of Radiology (M.K.), Cooper Medical School of Rowan University, Camden, NJ, USA; Department of Radiology (J.Y.M., H.A.S., M.S., H.L., V.S.Y), Department of Neurosurgery (R.X.), and Department of Neurology (V.C.U., E.B.M., R.L., M.B., R.H.L, A.E.H), Johns Hopkins Hospital, Baltimore, MD, USA; Department of Radiology (D.A.L.), West Virginia University Medicine, Morgantown, WV, USA; Department of Neuroradiology (A.A.D.), Massachusetts General Hospital &amp; Harvard Medical School, Boston, MA, USA; Department of Radiology (A.G.), Universite Libre De Bruxelles Hospital, Erasme, Belgium; Department of Radiology (J.J.H., B.P.), Department of Neurology (G.W.A.), Stanford University School of Medicine, Stanford, CA, USA; Department of Radiology (D.W.), Brown University/Rhode Island Hospital, Providence, RI, USA; Department of Radiology (T.D.F.), University Medical Center Munster, Munster, Germany; Department of Radiology (V.V.), Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA; Department of Radiology (A.S.), Department of Neurology (Y.A.), University of Cincinnati, Cincinnati, OH, USA; Department of Radiology and Biomedical Imaging (K.N.), University of California San Francisco, San Francisco, CA, USA." />
<meta name="citation_author" content="Gregory W. Albers" />
<meta name="citation_author_institution" content="From the Department of Radiology (M.K.), Cooper Medical School of Rowan University, Camden, NJ, USA; Department of Radiology (J.Y.M., H.A.S., M.S., H.L., V.S.Y), Department of Neurosurgery (R.X.), and Department of Neurology (V.C.U., E.B.M., R.L., M.B., R.H.L, A.E.H), Johns Hopkins Hospital, Baltimore, MD, USA; Department of Radiology (D.A.L.), West Virginia University Medicine, Morgantown, WV, USA; Department of Neuroradiology (A.A.D.), Massachusetts General Hospital &amp; Harvard Medical School, Boston, MA, USA; Department of Radiology (A.G.), Universite Libre De Bruxelles Hospital, Erasme, Belgium; Department of Radiology (J.J.H., B.P.), Department of Neurology (G.W.A.), Stanford University School of Medicine, Stanford, CA, USA; Department of Radiology (D.W.), Brown University/Rhode Island Hospital, Providence, RI, USA; Department of Radiology (T.D.F.), University Medical Center Munster, Munster, Germany; Department of Radiology (V.V.), Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA; Department of Radiology (A.S.), Department of Neurology (Y.A.), University of Cincinnati, Cincinnati, OH, USA; Department of Radiology and Biomedical Imaging (K.N.), University of California San Francisco, San Francisco, CA, USA." />
<meta name="citation_author" content="Dylan Wolman" />
<meta name="citation_author_institution" content="From the Department of Radiology (M.K.), Cooper Medical School of Rowan University, Camden, NJ, USA; Department of Radiology (J.Y.M., H.A.S., M.S., H.L., V.S.Y), Department of Neurosurgery (R.X.), and Department of Neurology (V.C.U., E.B.M., R.L., M.B., R.H.L, A.E.H), Johns Hopkins Hospital, Baltimore, MD, USA; Department of Radiology (D.A.L.), West Virginia University Medicine, Morgantown, WV, USA; Department of Neuroradiology (A.A.D.), Massachusetts General Hospital &amp; Harvard Medical School, Boston, MA, USA; Department of Radiology (A.G.), Universite Libre De Bruxelles Hospital, Erasme, Belgium; Department of Radiology (J.J.H., B.P.), Department of Neurology (G.W.A.), Stanford University School of Medicine, Stanford, CA, USA; Department of Radiology (D.W.), Brown University/Rhode Island Hospital, Providence, RI, USA; Department of Radiology (T.D.F.), University Medical Center Munster, Munster, Germany; Department of Radiology (V.V.), Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA; Department of Radiology (A.S.), Department of Neurology (Y.A.), University of Cincinnati, Cincinnati, OH, USA; Department of Radiology and Biomedical Imaging (K.N.), University of California San Francisco, San Francisco, CA, USA." />
<meta name="citation_author" content="Tobias D. Faizy" />
<meta name="citation_author_institution" content="From the Department of Radiology (M.K.), Cooper Medical School of Rowan University, Camden, NJ, USA; Department of Radiology (J.Y.M., H.A.S., M.S., H.L., V.S.Y), Department of Neurosurgery (R.X.), and Department of Neurology (V.C.U., E.B.M., R.L., M.B., R.H.L, A.E.H), Johns Hopkins Hospital, Baltimore, MD, USA; Department of Radiology (D.A.L.), West Virginia University Medicine, Morgantown, WV, USA; Department of Neuroradiology (A.A.D.), Massachusetts General Hospital &amp; Harvard Medical School, Boston, MA, USA; Department of Radiology (A.G.), Universite Libre De Bruxelles Hospital, Erasme, Belgium; Department of Radiology (J.J.H., B.P.), Department of Neurology (G.W.A.), Stanford University School of Medicine, Stanford, CA, USA; Department of Radiology (D.W.), Brown University/Rhode Island Hospital, Providence, RI, USA; Department of Radiology (T.D.F.), University Medical Center Munster, Munster, Germany; Department of Radiology (V.V.), Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA; Department of Radiology (A.S.), Department of Neurology (Y.A.), University of Cincinnati, Cincinnati, OH, USA; Department of Radiology and Biomedical Imaging (K.N.), University of California San Francisco, San Francisco, CA, USA." />
<meta name="citation_author" content="Benjamin Pulli" />
<meta name="citation_author_institution" content="From the Department of Radiology (M.K.), Cooper Medical School of Rowan University, Camden, NJ, USA; Department of Radiology (J.Y.M., H.A.S., M.S., H.L., V.S.Y), Department of Neurosurgery (R.X.), and Department of Neurology (V.C.U., E.B.M., R.L., M.B., R.H.L, A.E.H), Johns Hopkins Hospital, Baltimore, MD, USA; Department of Radiology (D.A.L.), West Virginia University Medicine, Morgantown, WV, USA; Department of Neuroradiology (A.A.D.), Massachusetts General Hospital &amp; Harvard Medical School, Boston, MA, USA; Department of Radiology (A.G.), Universite Libre De Bruxelles Hospital, Erasme, Belgium; Department of Radiology (J.J.H., B.P.), Department of Neurology (G.W.A.), Stanford University School of Medicine, Stanford, CA, USA; Department of Radiology (D.W.), Brown University/Rhode Island Hospital, Providence, RI, USA; Department of Radiology (T.D.F.), University Medical Center Munster, Munster, Germany; Department of Radiology (V.V.), Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA; Department of Radiology (A.S.), Department of Neurology (Y.A.), University of Cincinnati, Cincinnati, OH, USA; Department of Radiology and Biomedical Imaging (K.N.), University of California San Francisco, San Francisco, CA, USA." />
<meta name="citation_author" content="Vaibhav Vagal" />
<meta name="citation_author_institution" content="From the Department of Radiology (M.K.), Cooper Medical School of Rowan University, Camden, NJ, USA; Department of Radiology (J.Y.M., H.A.S., M.S., H.L., V.S.Y), Department of Neurosurgery (R.X.), and Department of Neurology (V.C.U., E.B.M., R.L., M.B., R.H.L, A.E.H), Johns Hopkins Hospital, Baltimore, MD, USA; Department of Radiology (D.A.L.), West Virginia University Medicine, Morgantown, WV, USA; Department of Neuroradiology (A.A.D.), Massachusetts General Hospital &amp; Harvard Medical School, Boston, MA, USA; Department of Radiology (A.G.), Universite Libre De Bruxelles Hospital, Erasme, Belgium; Department of Radiology (J.J.H., B.P.), Department of Neurology (G.W.A.), Stanford University School of Medicine, Stanford, CA, USA; Department of Radiology (D.W.), Brown University/Rhode Island Hospital, Providence, RI, USA; Department of Radiology (T.D.F.), University Medical Center Munster, Munster, Germany; Department of Radiology (V.V.), Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA; Department of Radiology (A.S.), Department of Neurology (Y.A.), University of Cincinnati, Cincinnati, OH, USA; Department of Radiology and Biomedical Imaging (K.N.), University of California San Francisco, San Francisco, CA, USA." />
<meta name="citation_author" content="Aakanksha Sriwastwa" />
<meta name="citation_author_institution" content="From the Department of Radiology (M.K.), Cooper Medical School of Rowan University, Camden, NJ, USA; Department of Radiology (J.Y.M., H.A.S., M.S., H.L., V.S.Y), Department of Neurosurgery (R.X.), and Department of Neurology (V.C.U., E.B.M., R.L., M.B., R.H.L, A.E.H), Johns Hopkins Hospital, Baltimore, MD, USA; Department of Radiology (D.A.L.), West Virginia University Medicine, Morgantown, WV, USA; Department of Neuroradiology (A.A.D.), Massachusetts General Hospital &amp; Harvard Medical School, Boston, MA, USA; Department of Radiology (A.G.), Universite Libre De Bruxelles Hospital, Erasme, Belgium; Department of Radiology (J.J.H., B.P.), Department of Neurology (G.W.A.), Stanford University School of Medicine, Stanford, CA, USA; Department of Radiology (D.W.), Brown University/Rhode Island Hospital, Providence, RI, USA; Department of Radiology (T.D.F.), University Medical Center Munster, Munster, Germany; Department of Radiology (V.V.), Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA; Department of Radiology (A.S.), Department of Neurology (Y.A.), University of Cincinnati, Cincinnati, OH, USA; Department of Radiology and Biomedical Imaging (K.N.), University of California San Francisco, San Francisco, CA, USA." />
<meta name="citation_author" content="Yasmin Aziz" />
<meta name="citation_author_institution" content="From the Department of Radiology (M.K.), Cooper Medical School of Rowan University, Camden, NJ, USA; Department of Radiology (J.Y.M., H.A.S., M.S., H.L., V.S.Y), Department of Neurosurgery (R.X.), and Department of Neurology (V.C.U., E.B.M., R.L., M.B., R.H.L, A.E.H), Johns Hopkins Hospital, Baltimore, MD, USA; Department of Radiology (D.A.L.), West Virginia University Medicine, Morgantown, WV, USA; Department of Neuroradiology (A.A.D.), Massachusetts General Hospital &amp; Harvard Medical School, Boston, MA, USA; Department of Radiology (A.G.), Universite Libre De Bruxelles Hospital, Erasme, Belgium; Department of Radiology (J.J.H., B.P.), Department of Neurology (G.W.A.), Stanford University School of Medicine, Stanford, CA, USA; Department of Radiology (D.W.), Brown University/Rhode Island Hospital, Providence, RI, USA; Department of Radiology (T.D.F.), University Medical Center Munster, Munster, Germany; Department of Radiology (V.V.), Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA; Department of Radiology (A.S.), Department of Neurology (Y.A.), University of Cincinnati, Cincinnati, OH, USA; Department of Radiology and Biomedical Imaging (K.N.), University of California San Francisco, San Francisco, CA, USA." />
<meta name="citation_author" content="Risheng Xu" />
<meta name="citation_author_institution" content="From the Department of Radiology (M.K.), Cooper Medical School of Rowan University, Camden, NJ, USA; Department of Radiology (J.Y.M., H.A.S., M.S., H.L., V.S.Y), Department of Neurosurgery (R.X.), and Department of Neurology (V.C.U., E.B.M., R.L., M.B., R.H.L, A.E.H), Johns Hopkins Hospital, Baltimore, MD, USA; Department of Radiology (D.A.L.), West Virginia University Medicine, Morgantown, WV, USA; Department of Neuroradiology (A.A.D.), Massachusetts General Hospital &amp; Harvard Medical School, Boston, MA, USA; Department of Radiology (A.G.), Universite Libre De Bruxelles Hospital, Erasme, Belgium; Department of Radiology (J.J.H., B.P.), Department of Neurology (G.W.A.), Stanford University School of Medicine, Stanford, CA, USA; Department of Radiology (D.W.), Brown University/Rhode Island Hospital, Providence, RI, USA; Department of Radiology (T.D.F.), University Medical Center Munster, Munster, Germany; Department of Radiology (V.V.), Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA; Department of Radiology (A.S.), Department of Neurology (Y.A.), University of Cincinnati, Cincinnati, OH, USA; Department of Radiology and Biomedical Imaging (K.N.), University of California San Francisco, San Francisco, CA, USA." />
<meta name="citation_author" content="Hanzhang Lu" />
<meta name="citation_author_institution" content="From the Department of Radiology (M.K.), Cooper Medical School of Rowan University, Camden, NJ, USA; Department of Radiology (J.Y.M., H.A.S., M.S., H.L., V.S.Y), Department of Neurosurgery (R.X.), and Department of Neurology (V.C.U., E.B.M., R.L., M.B., R.H.L, A.E.H), Johns Hopkins Hospital, Baltimore, MD, USA; Department of Radiology (D.A.L.), West Virginia University Medicine, Morgantown, WV, USA; Department of Neuroradiology (A.A.D.), Massachusetts General Hospital &amp; Harvard Medical School, Boston, MA, USA; Department of Radiology (A.G.), Universite Libre De Bruxelles Hospital, Erasme, Belgium; Department of Radiology (J.J.H., B.P.), Department of Neurology (G.W.A.), Stanford University School of Medicine, Stanford, CA, USA; Department of Radiology (D.W.), Brown University/Rhode Island Hospital, Providence, RI, USA; Department of Radiology (T.D.F.), University Medical Center Munster, Munster, Germany; Department of Radiology (V.V.), Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA; Department of Radiology (A.S.), Department of Neurology (Y.A.), University of Cincinnati, Cincinnati, OH, USA; Department of Radiology and Biomedical Imaging (K.N.), University of California San Francisco, San Francisco, CA, USA." />
<meta name="citation_author" content="Victor C. Urrutia" />
<meta name="citation_author_institution" content="From the Department of Radiology (M.K.), Cooper Medical School of Rowan University, Camden, NJ, USA; Department of Radiology (J.Y.M., H.A.S., M.S., H.L., V.S.Y), Department of Neurosurgery (R.X.), and Department of Neurology (V.C.U., E.B.M., R.L., M.B., R.H.L, A.E.H), Johns Hopkins Hospital, Baltimore, MD, USA; Department of Radiology (D.A.L.), West Virginia University Medicine, Morgantown, WV, USA; Department of Neuroradiology (A.A.D.), Massachusetts General Hospital &amp; Harvard Medical School, Boston, MA, USA; Department of Radiology (A.G.), Universite Libre De Bruxelles Hospital, Erasme, Belgium; Department of Radiology (J.J.H., B.P.), Department of Neurology (G.W.A.), Stanford University School of Medicine, Stanford, CA, USA; Department of Radiology (D.W.), Brown University/Rhode Island Hospital, Providence, RI, USA; Department of Radiology (T.D.F.), University Medical Center Munster, Munster, Germany; Department of Radiology (V.V.), Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA; Department of Radiology (A.S.), Department of Neurology (Y.A.), University of Cincinnati, Cincinnati, OH, USA; Department of Radiology and Biomedical Imaging (K.N.), University of California San Francisco, San Francisco, CA, USA." />
<meta name="citation_author" content="Elisabeth B. Marsh" />
<meta name="citation_author_institution" content="From the Department of Radiology (M.K.), Cooper Medical School of Rowan University, Camden, NJ, USA; Department of Radiology (J.Y.M., H.A.S., M.S., H.L., V.S.Y), Department of Neurosurgery (R.X.), and Department of Neurology (V.C.U., E.B.M., R.L., M.B., R.H.L, A.E.H), Johns Hopkins Hospital, Baltimore, MD, USA; Department of Radiology (D.A.L.), West Virginia University Medicine, Morgantown, WV, USA; Department of Neuroradiology (A.A.D.), Massachusetts General Hospital &amp; Harvard Medical School, Boston, MA, USA; Department of Radiology (A.G.), Universite Libre De Bruxelles Hospital, Erasme, Belgium; Department of Radiology (J.J.H., B.P.), Department of Neurology (G.W.A.), Stanford University School of Medicine, Stanford, CA, USA; Department of Radiology (D.W.), Brown University/Rhode Island Hospital, Providence, RI, USA; Department of Radiology (T.D.F.), University Medical Center Munster, Munster, Germany; Department of Radiology (V.V.), Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA; Department of Radiology (A.S.), Department of Neurology (Y.A.), University of Cincinnati, Cincinnati, OH, USA; Department of Radiology and Biomedical Imaging (K.N.), University of California San Francisco, San Francisco, CA, USA." />
<meta name="citation_author" content="Richard Leigh" />
<meta name="citation_author_institution" content="From the Department of Radiology (M.K.), Cooper Medical School of Rowan University, Camden, NJ, USA; Department of Radiology (J.Y.M., H.A.S., M.S., H.L., V.S.Y), Department of Neurosurgery (R.X.), and Department of Neurology (V.C.U., E.B.M., R.L., M.B., R.H.L, A.E.H), Johns Hopkins Hospital, Baltimore, MD, USA; Department of Radiology (D.A.L.), West Virginia University Medicine, Morgantown, WV, USA; Department of Neuroradiology (A.A.D.), Massachusetts General Hospital &amp; Harvard Medical School, Boston, MA, USA; Department of Radiology (A.G.), Universite Libre De Bruxelles Hospital, Erasme, Belgium; Department of Radiology (J.J.H., B.P.), Department of Neurology (G.W.A.), Stanford University School of Medicine, Stanford, CA, USA; Department of Radiology (D.W.), Brown University/Rhode Island Hospital, Providence, RI, USA; Department of Radiology (T.D.F.), University Medical Center Munster, Munster, Germany; Department of Radiology (V.V.), Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA; Department of Radiology (A.S.), Department of Neurology (Y.A.), University of Cincinnati, Cincinnati, OH, USA; Department of Radiology and Biomedical Imaging (K.N.), University of California San Francisco, San Francisco, CA, USA." />
<meta name="citation_author" content="Mona Bahouth" />
<meta name="citation_author_institution" content="From the Department of Radiology (M.K.), Cooper Medical School of Rowan University, Camden, NJ, USA; Department of Radiology (J.Y.M., H.A.S., M.S., H.L., V.S.Y), Department of Neurosurgery (R.X.), and Department of Neurology (V.C.U., E.B.M., R.L., M.B., R.H.L, A.E.H), Johns Hopkins Hospital, Baltimore, MD, USA; Department of Radiology (D.A.L.), West Virginia University Medicine, Morgantown, WV, USA; Department of Neuroradiology (A.A.D.), Massachusetts General Hospital &amp; Harvard Medical School, Boston, MA, USA; Department of Radiology (A.G.), Universite Libre De Bruxelles Hospital, Erasme, Belgium; Department of Radiology (J.J.H., B.P.), Department of Neurology (G.W.A.), Stanford University School of Medicine, Stanford, CA, USA; Department of Radiology (D.W.), Brown University/Rhode Island Hospital, Providence, RI, USA; Department of Radiology (T.D.F.), University Medical Center Munster, Munster, Germany; Department of Radiology (V.V.), Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA; Department of Radiology (A.S.), Department of Neurology (Y.A.), University of Cincinnati, Cincinnati, OH, USA; Department of Radiology and Biomedical Imaging (K.N.), University of California San Francisco, San Francisco, CA, USA." />
<meta name="citation_author" content="Rafael H. Llinas" />
<meta name="citation_author_institution" content="From the Department of Radiology (M.K.), Cooper Medical School of Rowan University, Camden, NJ, USA; Department of Radiology (J.Y.M., H.A.S., M.S., H.L., V.S.Y), Department of Neurosurgery (R.X.), and Department of Neurology (V.C.U., E.B.M., R.L., M.B., R.H.L, A.E.H), Johns Hopkins Hospital, Baltimore, MD, USA; Department of Radiology (D.A.L.), West Virginia University Medicine, Morgantown, WV, USA; Department of Neuroradiology (A.A.D.), Massachusetts General Hospital &amp; Harvard Medical School, Boston, MA, USA; Department of Radiology (A.G.), Universite Libre De Bruxelles Hospital, Erasme, Belgium; Department of Radiology (J.J.H., B.P.), Department of Neurology (G.W.A.), Stanford University School of Medicine, Stanford, CA, USA; Department of Radiology (D.W.), Brown University/Rhode Island Hospital, Providence, RI, USA; Department of Radiology (T.D.F.), University Medical Center Munster, Munster, Germany; Department of Radiology (V.V.), Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA; Department of Radiology (A.S.), Department of Neurology (Y.A.), University of Cincinnati, Cincinnati, OH, USA; Department of Radiology and Biomedical Imaging (K.N.), University of California San Francisco, San Francisco, CA, USA." />
<meta name="citation_author" content="Kambiz Nael" />
<meta name="citation_author_institution" content="From the Department of Radiology (M.K.), Cooper Medical School of Rowan University, Camden, NJ, USA; Department of Radiology (J.Y.M., H.A.S., M.S., H.L., V.S.Y), Department of Neurosurgery (R.X.), and Department of Neurology (V.C.U., E.B.M., R.L., M.B., R.H.L, A.E.H), Johns Hopkins Hospital, Baltimore, MD, USA; Department of Radiology (D.A.L.), West Virginia University Medicine, Morgantown, WV, USA; Department of Neuroradiology (A.A.D.), Massachusetts General Hospital &amp; Harvard Medical School, Boston, MA, USA; Department of Radiology (A.G.), Universite Libre De Bruxelles Hospital, Erasme, Belgium; Department of Radiology (J.J.H., B.P.), Department of Neurology (G.W.A.), Stanford University School of Medicine, Stanford, CA, USA; Department of Radiology (D.W.), Brown University/Rhode Island Hospital, Providence, RI, USA; Department of Radiology (T.D.F.), University Medical Center Munster, Munster, Germany; Department of Radiology (V.V.), Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA; Department of Radiology (A.S.), Department of Neurology (Y.A.), University of Cincinnati, Cincinnati, OH, USA; Department of Radiology and Biomedical Imaging (K.N.), University of California San Francisco, San Francisco, CA, USA." />
<meta name="citation_author" content="ArgyeE. Hillis" />
<meta name="citation_author_institution" content="From the Department of Radiology (M.K.), Cooper Medical School of Rowan University, Camden, NJ, USA; Department of Radiology (J.Y.M., H.A.S., M.S., H.L., V.S.Y), Department of Neurosurgery (R.X.), and Department of Neurology (V.C.U., E.B.M., R.L., M.B., R.H.L, A.E.H), Johns Hopkins Hospital, Baltimore, MD, USA; Department of Radiology (D.A.L.), West Virginia University Medicine, Morgantown, WV, USA; Department of Neuroradiology (A.A.D.), Massachusetts General Hospital &amp; Harvard Medical School, Boston, MA, USA; Department of Radiology (A.G.), Universite Libre De Bruxelles Hospital, Erasme, Belgium; Department of Radiology (J.J.H., B.P.), Department of Neurology (G.W.A.), Stanford University School of Medicine, Stanford, CA, USA; Department of Radiology (D.W.), Brown University/Rhode Island Hospital, Providence, RI, USA; Department of Radiology (T.D.F.), University Medical Center Munster, Munster, Germany; Department of Radiology (V.V.), Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA; Department of Radiology (A.S.), Department of Neurology (Y.A.), University of Cincinnati, Cincinnati, OH, USA; Department of Radiology and Biomedical Imaging (K.N.), University of California San Francisco, San Francisco, CA, USA." />
<meta name="citation_author" content="Vivek S. Yedavalli" />
<meta name="citation_author_institution" content="From the Department of Radiology (M.K.), Cooper Medical School of Rowan University, Camden, NJ, USA; Department of Radiology (J.Y.M., H.A.S., M.S., H.L., V.S.Y), Department of Neurosurgery (R.X.), and Department of Neurology (V.C.U., E.B.M., R.L., M.B., R.H.L, A.E.H), Johns Hopkins Hospital, Baltimore, MD, USA; Department of Radiology (D.A.L.), West Virginia University Medicine, Morgantown, WV, USA; Department of Neuroradiology (A.A.D.), Massachusetts General Hospital &amp; Harvard Medical School, Boston, MA, USA; Department of Radiology (A.G.), Universite Libre De Bruxelles Hospital, Erasme, Belgium; Department of Radiology (J.J.H., B.P.), Department of Neurology (G.W.A.), Stanford University School of Medicine, Stanford, CA, USA; Department of Radiology (D.W.), Brown University/Rhode Island Hospital, Providence, RI, USA; Department of Radiology (T.D.F.), University Medical Center Munster, Munster, Germany; Department of Radiology (V.V.), Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA; Department of Radiology (A.S.), Department of Neurology (Y.A.), University of Cincinnati, Cincinnati, OH, USA; Department of Radiology and Biomedical Imaging (K.N.), University of California San Francisco, San Francisco, CA, USA." />
<meta name="twitter:title" content="Prolonged Venous Transit on Perfusion Imaging is Associated with Longer Lengths of Stay in Acute Large Vessel Occlusions" />
<meta name="twitter:card" content="summary" />
<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Prolonged venous transit (PVT+) is a marker of venous outflow; it is defined as the presence or absence of time-to-maximum ≥10 seconds timing in either the superior sagittal sinus or torcula. This novel perfusion imaging-based metric has been associated with higher odds of mortality and lower odds of functional recovery. This study aims to assess the relationship between PVT on admission perfusion imaging and length of hospital stay in large vessel occlusion strokes successfully reperfused with mechanical thrombectomy.

MATERIALS AND METHODS: Acute ischemic stroke patients with large vessel occlusions in the anterior circulation successfully treated with thrombectomy between 01/2017 and 09/2022 were retrospectively reviewed. The primary outcome was length of stay in the hospital due to the acute stroke event. Univariable and forward stepwise multivariable linear regressions were performed for the primary outcome.

RESULTS: Of 109 patients meeting inclusion, median age was 71 (interquartile range [IQR] 62-80) years. Median hospital length of stay was significantly greater in PVT+ patients (9 [IQR 6-18] days) compared to PVT-patients (6 [IQR 4-12] days, p=0.03). In multivariable regression, PVT+ was significantly associated with length of stay, and PVT+ was associated with approximately two additional days of hospital stay compared to PVT-(p=0.03).

CONCLUSIONS: In successfully reperfused large vessel occlusion strokes, PVT+ was associated with an additional two days of hospital stay on average compared to PVT-patients, when adjusting for other clinical covariables. This simple, novel imaging metric is robust in correlating with a range of short and long term clinical outcomes.

ABBREVIATIONS: VO = venous outflow; Tmax = time-to-maximum; PVT = prolonged venous transit; AIS-LVO = large vessel occlusion ischemic stroke; SSS = superior sagittal sinus; rCBF = relative cerebral blood flow; IQR = interquartile range; VIF = variance inflation factor." />
<meta name="og-title" property="og:title" content="Prolonged Venous Transit on Perfusion Imaging is Associated with Longer Lengths of Stay in Acute Large Vessel Occlusions" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/early/2024/11/26/ajnr.A8611" />
<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: Prolonged venous transit (PVT+) is a marker of venous outflow; it is defined as the presence or absence of time-to-maximum ≥10 seconds timing in either the superior sagittal sinus or torcula. This novel perfusion imaging-based metric has been associated with higher odds of mortality and lower odds of functional recovery. This study aims to assess the relationship between PVT on admission perfusion imaging and length of hospital stay in large vessel occlusion strokes successfully reperfused with mechanical thrombectomy.

MATERIALS AND METHODS: Acute ischemic stroke patients with large vessel occlusions in the anterior circulation successfully treated with thrombectomy between 01/2017 and 09/2022 were retrospectively reviewed. The primary outcome was length of stay in the hospital due to the acute stroke event. Univariable and forward stepwise multivariable linear regressions were performed for the primary outcome.

RESULTS: Of 109 patients meeting inclusion, median age was 71 (interquartile range [IQR] 62-80) years. Median hospital length of stay was significantly greater in PVT+ patients (9 [IQR 6-18] days) compared to PVT-patients (6 [IQR 4-12] days, p=0.03). In multivariable regression, PVT+ was significantly associated with length of stay, and PVT+ was associated with approximately two additional days of hospital stay compared to PVT-(p=0.03).

CONCLUSIONS: In successfully reperfused large vessel occlusion strokes, PVT+ was associated with an additional two days of hospital stay on average compared to PVT-patients, when adjusting for other clinical covariables. This simple, novel imaging metric is robust in correlating with a range of short and long term clinical outcomes.

ABBREVIATIONS: VO = venous outflow; Tmax = time-to-maximum; PVT = prolonged venous transit; AIS-LVO = large vessel occlusion ischemic stroke; SSS = superior sagittal sinus; rCBF = relative cerebral blood flow; IQR = interquartile range; VIF = variance inflation factor." />
<meta name="og-type" property="og:type" content="article" />
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    <div class="highwire-article-citation highwire-citation-type-highwire-article node112006--5" data-node-nid="112006" id="top-node-112006--61413836797" data-pisa="ajnr;ajnr.A8611v1" data-pisa-master="ajnr;ajnr.A8611" data-apath="/ajnr/early/2024/11/26/ajnr.A8611.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">ORIGINAL RESEARCH</span></span></div>
  
      <div class="highwire-cite-access"><span class="highwire-citation-access highwire-citation-access-check" data-pisa-id="ajnr;ajnr.A8611" data-atom-uri="/ajnr/early/2024/11/26/ajnr.A8611.atom" data-request-view="full"></span></div>
  
      <h1 class="highwire-cite-title" id="page-title">Prolonged Venous Transit on Perfusion Imaging is Associated with Longer Lengths of Stay in Acute Large Vessel Occlusions</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">Manisha Koneru</span>, <span class="highwire-citation-author" data-delta="1">Janet Y. Mei</span>, <span class="highwire-citation-author" data-delta="2">Dhairya A. Lakhani</span>, <span class="highwire-citation-author" data-delta="3">Hamza A. Salim</span>, <span class="highwire-citation-author" data-delta="4">Mona Shahriari</span>, <span class="highwire-citation-author" data-delta="5">Adam A. Dmytriw</span>, <span class="highwire-citation-author" data-delta="6">Adrien Guenego</span>, <span class="highwire-citation-author" data-delta="7">Jeremy J. Heit</span>, <span class="highwire-citation-author" data-delta="8">Gregory W. Albers</span>, <span class="highwire-citation-author" data-delta="9">Dylan Wolman</span>, <span class="highwire-citation-author" data-delta="10">Tobias D. Faizy</span>, <span class="highwire-citation-author" data-delta="11">Benjamin Pulli</span>, <span class="highwire-citation-author" data-delta="12">Vaibhav Vagal</span>, <span class="highwire-citation-author" data-delta="13">Aakanksha Sriwastwa</span>, <span class="highwire-citation-author" data-delta="14">Yasmin Aziz</span>, <span class="highwire-citation-author" data-delta="15">Risheng Xu</span>, <span class="highwire-citation-author" data-delta="16">Hanzhang Lu</span>, <span class="highwire-citation-author" data-delta="17">Victor C. Urrutia</span>, <span class="highwire-citation-author" data-delta="18">Elisabeth B. Marsh</span>, <span class="highwire-citation-author" data-delta="19">Richard Leigh</span>, <span class="highwire-citation-author" data-delta="20">Mona Bahouth</span>, <span class="highwire-citation-author" data-delta="21">Rafael H. Llinas</span>, <span class="highwire-citation-author" data-delta="22">Kambiz Nael</span>, <span class="highwire-citation-author" data-delta="23">ArgyeE. Hillis</span> and <span class="highwire-citation-author" data-delta="24">Vivek S. Yedavalli</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-pages highwire-cite-metadata">ajnr.A8611; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A8611 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-112006--61413836797" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">Manisha Koneru </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Department of Radiology (M.K.), Cooper Medical School of Rowan University, Camden, NJ, USA; Department of Radiology (J.Y.M., H.A.S., M.S., H.L., V.S.Y), Department of Neurosurgery (R.X.), and Department of Neurology (V.C.U., E.B.M., R.L., M.B., R.H.L, A.E.H), Johns Hopkins Hospital, Baltimore, MD, USA; Department of Radiology (D.A.L.), West Virginia University Medicine, Morgantown, WV, USA; Department of Neuroradiology (A.A.D.), Massachusetts General Hospital & Harvard Medical School, Boston, MA, USA; Department of Radiology (A.G.), Universite Libre De Bruxelles Hospital, Erasme, Belgium; Department of Radiology (J.J.H., B.P.), Department of Neurology (G.W.A.), Stanford University School of Medicine, Stanford, CA, USA; Department of Radiology (D.W.), Brown University/Rhode Island Hospital, Providence, RI, USA; Department of Radiology (T.D.F.), University Medical Center Munster, Munster, Germany; Department of Radiology (V.V.), Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA; Department of Radiology (A.S.), Department of Neurology (Y.A.), University of Cincinnati, Cincinnati, OH, USA; Department of Radiology and Biomedical Imaging (K.N.), University of California San Francisco, San Francisco, CA, USA.</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=Manisha%2BKoneru%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=Koneru%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 last"><a href="/search/author1%3AManisha%2BKoneru%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">Janet Y. Mei </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Department of Radiology (M.K.), Cooper Medical School of Rowan University, Camden, NJ, USA; Department of Radiology (J.Y.M., H.A.S., M.S., H.L., V.S.Y), Department of Neurosurgery (R.X.), and Department of Neurology (V.C.U., E.B.M., R.L., M.B., R.H.L, A.E.H), Johns Hopkins Hospital, Baltimore, MD, USA; Department of Radiology (D.A.L.), West Virginia University Medicine, Morgantown, WV, USA; Department of Neuroradiology (A.A.D.), Massachusetts General Hospital & Harvard Medical School, Boston, MA, USA; Department of Radiology (A.G.), Universite Libre De Bruxelles Hospital, Erasme, Belgium; Department of Radiology (J.J.H., B.P.), Department of Neurology (G.W.A.), Stanford University School of Medicine, Stanford, CA, USA; Department of Radiology (D.W.), Brown University/Rhode Island Hospital, Providence, RI, USA; Department of Radiology (T.D.F.), University Medical Center Munster, Munster, Germany; Department of Radiology (V.V.), Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA; Department of Radiology (A.S.), Department of Neurology (Y.A.), University of Cincinnati, Cincinnati, OH, USA; Department of Radiology and Biomedical Imaging (K.N.), University of California San Francisco, San Francisco, CA, USA.</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=Janet%2BY.%2BMei%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=Mei%20JY&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%3AJanet%2BY.%2BMei%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">Dhairya A. Lakhani </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Department of Radiology (M.K.), Cooper Medical School of Rowan University, Camden, NJ, USA; Department of Radiology (J.Y.M., H.A.S., M.S., H.L., V.S.Y), Department of Neurosurgery (R.X.), and Department of Neurology (V.C.U., E.B.M., R.L., M.B., R.H.L, A.E.H), Johns Hopkins Hospital, Baltimore, MD, USA; Department of Radiology (D.A.L.), West Virginia University Medicine, Morgantown, WV, USA; Department of Neuroradiology (A.A.D.), Massachusetts General Hospital & Harvard Medical School, Boston, MA, USA; Department of Radiology (A.G.), Universite Libre De Bruxelles Hospital, Erasme, Belgium; Department of Radiology (J.J.H., B.P.), Department of Neurology (G.W.A.), Stanford University School of Medicine, Stanford, CA, USA; Department of Radiology (D.W.), Brown University/Rhode Island Hospital, Providence, RI, USA; Department of Radiology (T.D.F.), University Medical Center Munster, Munster, Germany; Department of Radiology (V.V.), Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA; Department of Radiology (A.S.), Department of Neurology (Y.A.), University of Cincinnati, Cincinnati, OH, USA; Department of Radiology and Biomedical Imaging (K.N.), University of California San Francisco, San Francisco, CA, USA.</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=Dhairya%2BA.%2BLakhani%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=Lakhani%20DA&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%3ADhairya%2BA.%2BLakhani%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">Hamza A. Salim </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Department of Radiology (M.K.), Cooper Medical School of Rowan University, Camden, NJ, USA; Department of Radiology (J.Y.M., H.A.S., M.S., H.L., V.S.Y), Department of Neurosurgery (R.X.), and Department of Neurology (V.C.U., E.B.M., R.L., M.B., R.H.L, A.E.H), Johns Hopkins Hospital, Baltimore, MD, USA; Department of Radiology (D.A.L.), West Virginia University Medicine, Morgantown, WV, USA; Department of Neuroradiology (A.A.D.), Massachusetts General Hospital & Harvard Medical School, Boston, MA, USA; Department of Radiology (A.G.), Universite Libre De Bruxelles Hospital, Erasme, Belgium; Department of Radiology (J.J.H., B.P.), Department of Neurology (G.W.A.), Stanford University School of Medicine, Stanford, CA, USA; Department of Radiology (D.W.), Brown University/Rhode Island Hospital, Providence, RI, USA; Department of Radiology (T.D.F.), University Medical Center Munster, Munster, Germany; Department of Radiology (V.V.), Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA; Department of Radiology (A.S.), Department of Neurology (Y.A.), University of Cincinnati, Cincinnati, OH, USA; Department of Radiology and Biomedical Imaging (K.N.), University of California San Francisco, San Francisco, CA, USA.</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=Hamza%2BA.%2BSalim%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=Salim%20HA&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%3AHamza%2BA.%2BSalim%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-4"><div class="author-tooltip-name">Mona Shahriari </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Department of Radiology (M.K.), Cooper Medical School of Rowan University, Camden, NJ, USA; Department of Radiology (J.Y.M., H.A.S., M.S., H.L., V.S.Y), Department of Neurosurgery (R.X.), and Department of Neurology (V.C.U., E.B.M., R.L., M.B., R.H.L, A.E.H), Johns Hopkins Hospital, Baltimore, MD, USA; Department of Radiology (D.A.L.), West Virginia University Medicine, Morgantown, WV, USA; Department of Neuroradiology (A.A.D.), Massachusetts General Hospital & Harvard Medical School, Boston, MA, USA; Department of Radiology (A.G.), Universite Libre De Bruxelles Hospital, Erasme, Belgium; Department of Radiology (J.J.H., B.P.), Department of Neurology (G.W.A.), Stanford University School of Medicine, Stanford, CA, USA; Department of Radiology (D.W.), Brown University/Rhode Island Hospital, Providence, RI, USA; Department of Radiology (T.D.F.), University Medical Center Munster, Munster, Germany; Department of Radiology (V.V.), Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA; Department of Radiology (A.S.), Department of Neurology (Y.A.), University of Cincinnati, Cincinnati, OH, USA; Department of Radiology and Biomedical Imaging (K.N.), University of California San Francisco, San Francisco, CA, USA.</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=Mona%2BShahriari%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=Shahriari%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 last"><a href="/search/author1%3AMona%2BShahriari%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-5"><div class="author-tooltip-name">Adam A. Dmytriw </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Department of Radiology (M.K.), Cooper Medical School of Rowan University, Camden, NJ, USA; Department of Radiology (J.Y.M., H.A.S., M.S., H.L., V.S.Y), Department of Neurosurgery (R.X.), and Department of Neurology (V.C.U., E.B.M., R.L., M.B., R.H.L, A.E.H), Johns Hopkins Hospital, Baltimore, MD, USA; Department of Radiology (D.A.L.), West Virginia University Medicine, Morgantown, WV, USA; Department of Neuroradiology (A.A.D.), Massachusetts General Hospital & Harvard Medical School, Boston, MA, USA; Department of Radiology (A.G.), Universite Libre De Bruxelles Hospital, Erasme, Belgium; Department of Radiology (J.J.H., B.P.), Department of Neurology (G.W.A.), Stanford University School of Medicine, Stanford, CA, USA; Department of Radiology (D.W.), Brown University/Rhode Island Hospital, Providence, RI, USA; Department of Radiology (T.D.F.), University Medical Center Munster, Munster, Germany; Department of Radiology (V.V.), Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA; Department of Radiology (A.S.), Department of Neurology (Y.A.), University of Cincinnati, Cincinnati, OH, USA; Department of Radiology and Biomedical Imaging (K.N.), University of California San Francisco, San Francisco, CA, USA.</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=Adam%2BA.%2BDmytriw%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=Dmytriw%20AA&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%3AAdam%2BA.%2BDmytriw%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-6"><div class="author-tooltip-name">Adrien Guenego </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Department of Radiology (M.K.), Cooper Medical School of Rowan University, Camden, NJ, USA; Department of Radiology (J.Y.M., H.A.S., M.S., H.L., V.S.Y), Department of Neurosurgery (R.X.), and Department of Neurology (V.C.U., E.B.M., R.L., M.B., R.H.L, A.E.H), Johns Hopkins Hospital, Baltimore, MD, USA; Department of Radiology (D.A.L.), West Virginia University Medicine, Morgantown, WV, USA; Department of Neuroradiology (A.A.D.), Massachusetts General Hospital & Harvard Medical School, Boston, MA, USA; Department of Radiology (A.G.), Universite Libre De Bruxelles Hospital, Erasme, Belgium; Department of Radiology (J.J.H., B.P.), Department of Neurology (G.W.A.), Stanford University School of Medicine, Stanford, CA, USA; Department of Radiology (D.W.), Brown University/Rhode Island Hospital, Providence, RI, USA; Department of Radiology (T.D.F.), University Medical Center Munster, Munster, Germany; Department of Radiology (V.V.), Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA; Department of Radiology (A.S.), Department of Neurology (Y.A.), University of Cincinnati, Cincinnati, OH, USA; Department of Radiology and Biomedical Imaging (K.N.), University of California San Francisco, San Francisco, CA, USA.</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=Adrien%2BGuenego%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=Guenego%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 last"><a href="/search/author1%3AAdrien%2BGuenego%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-7"><div class="author-tooltip-name">Jeremy J. Heit </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Department of Radiology (M.K.), Cooper Medical School of Rowan University, Camden, NJ, USA; Department of Radiology (J.Y.M., H.A.S., M.S., H.L., V.S.Y), Department of Neurosurgery (R.X.), and Department of Neurology (V.C.U., E.B.M., R.L., M.B., R.H.L, A.E.H), Johns Hopkins Hospital, Baltimore, MD, USA; Department of Radiology (D.A.L.), West Virginia University Medicine, Morgantown, WV, USA; Department of Neuroradiology (A.A.D.), Massachusetts General Hospital & Harvard Medical School, Boston, MA, USA; Department of Radiology (A.G.), Universite Libre De Bruxelles Hospital, Erasme, Belgium; Department of Radiology (J.J.H., B.P.), Department of Neurology (G.W.A.), Stanford University School of Medicine, Stanford, CA, USA; Department of Radiology (D.W.), Brown University/Rhode Island Hospital, Providence, RI, USA; Department of Radiology (T.D.F.), University Medical Center Munster, Munster, Germany; Department of Radiology (V.V.), Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA; Department of Radiology (A.S.), Department of Neurology (Y.A.), University of Cincinnati, Cincinnati, OH, USA; Department of Radiology and Biomedical Imaging (K.N.), University of California San Francisco, San Francisco, CA, USA.</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=Jeremy%2BJ.%2BHeit%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=Heit%20JJ&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%3AJeremy%2BJ.%2BHeit%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-8"><div class="author-tooltip-name">Gregory W. Albers </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Department of Radiology (M.K.), Cooper Medical School of Rowan University, Camden, NJ, USA; Department of Radiology (J.Y.M., H.A.S., M.S., H.L., V.S.Y), Department of Neurosurgery (R.X.), and Department of Neurology (V.C.U., E.B.M., R.L., M.B., R.H.L, A.E.H), Johns Hopkins Hospital, Baltimore, MD, USA; Department of Radiology (D.A.L.), West Virginia University Medicine, Morgantown, WV, USA; Department of Neuroradiology (A.A.D.), Massachusetts General Hospital & Harvard Medical School, Boston, MA, USA; Department of Radiology (A.G.), Universite Libre De Bruxelles Hospital, Erasme, Belgium; Department of Radiology (J.J.H., B.P.), Department of Neurology (G.W.A.), Stanford University School of Medicine, Stanford, CA, USA; Department of Radiology (D.W.), Brown University/Rhode Island Hospital, Providence, RI, USA; Department of Radiology (T.D.F.), University Medical Center Munster, Munster, Germany; Department of Radiology (V.V.), Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA; Department of Radiology (A.S.), Department of Neurology (Y.A.), University of Cincinnati, Cincinnati, OH, USA; Department of Radiology and Biomedical Imaging (K.N.), University of California San Francisco, San Francisco, CA, USA.</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=Gregory%2BW.%2BAlbers%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=Albers%20GW&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%3AGregory%2BW.%2BAlbers%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-9"><div class="author-tooltip-name">Dylan Wolman </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Department of Radiology (M.K.), Cooper Medical School of Rowan University, Camden, NJ, USA; Department of Radiology (J.Y.M., H.A.S., M.S., H.L., V.S.Y), Department of Neurosurgery (R.X.), and Department of Neurology (V.C.U., E.B.M., R.L., M.B., R.H.L, A.E.H), Johns Hopkins Hospital, Baltimore, MD, USA; Department of Radiology (D.A.L.), West Virginia University Medicine, Morgantown, WV, USA; Department of Neuroradiology (A.A.D.), Massachusetts General Hospital & Harvard Medical School, Boston, MA, USA; Department of Radiology (A.G.), Universite Libre De Bruxelles Hospital, Erasme, Belgium; Department of Radiology (J.J.H., B.P.), Department of Neurology (G.W.A.), Stanford University School of Medicine, Stanford, CA, USA; Department of Radiology (D.W.), Brown University/Rhode Island Hospital, Providence, RI, USA; Department of Radiology (T.D.F.), University Medical Center Munster, Munster, Germany; Department of Radiology (V.V.), Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA; Department of Radiology (A.S.), Department of Neurology (Y.A.), University of Cincinnati, Cincinnati, OH, USA; Department of Radiology and Biomedical Imaging (K.N.), University of California San Francisco, San Francisco, CA, USA.</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=Dylan%2BWolman%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=Wolman%20D&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%3ADylan%2BWolman%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-10"><div class="author-tooltip-name">Tobias D. Faizy </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Department of Radiology (M.K.), Cooper Medical School of Rowan University, Camden, NJ, USA; Department of Radiology (J.Y.M., H.A.S., M.S., H.L., V.S.Y), Department of Neurosurgery (R.X.), and Department of Neurology (V.C.U., E.B.M., R.L., M.B., R.H.L, A.E.H), Johns Hopkins Hospital, Baltimore, MD, USA; Department of Radiology (D.A.L.), West Virginia University Medicine, Morgantown, WV, USA; Department of Neuroradiology (A.A.D.), Massachusetts General Hospital & Harvard Medical School, Boston, MA, USA; Department of Radiology (A.G.), Universite Libre De Bruxelles Hospital, Erasme, Belgium; Department of Radiology (J.J.H., B.P.), Department of Neurology (G.W.A.), Stanford University School of Medicine, Stanford, CA, USA; Department of Radiology (D.W.), Brown University/Rhode Island Hospital, Providence, RI, USA; Department of Radiology (T.D.F.), University Medical Center Munster, Munster, Germany; Department of Radiology (V.V.), Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA; Department of Radiology (A.S.), Department of Neurology (Y.A.), University of Cincinnati, Cincinnati, OH, USA; Department of Radiology and Biomedical Imaging (K.N.), University of California San Francisco, San Francisco, CA, USA.</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=Tobias%2BD.%2BFaizy%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=Faizy%20TD&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%3ATobias%2BD.%2BFaizy%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-11"><div class="author-tooltip-name">Benjamin Pulli </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Department of Radiology (M.K.), Cooper Medical School of Rowan University, Camden, NJ, USA; Department of Radiology (J.Y.M., H.A.S., M.S., H.L., V.S.Y), Department of Neurosurgery (R.X.), and Department of Neurology (V.C.U., E.B.M., R.L., M.B., R.H.L, A.E.H), Johns Hopkins Hospital, Baltimore, MD, USA; Department of Radiology (D.A.L.), West Virginia University Medicine, Morgantown, WV, USA; Department of Neuroradiology (A.A.D.), Massachusetts General Hospital & Harvard Medical School, Boston, MA, USA; Department of Radiology (A.G.), Universite Libre De Bruxelles Hospital, Erasme, Belgium; Department of Radiology (J.J.H., B.P.), Department of Neurology (G.W.A.), Stanford University School of Medicine, Stanford, CA, USA; Department of Radiology (D.W.), Brown University/Rhode Island Hospital, Providence, RI, USA; Department of Radiology (T.D.F.), University Medical Center Munster, Munster, Germany; Department of Radiology (V.V.), Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA; Department of Radiology (A.S.), Department of Neurology (Y.A.), University of Cincinnati, Cincinnati, OH, USA; Department of Radiology and Biomedical Imaging (K.N.), University of California San Francisco, San Francisco, CA, USA.</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=Benjamin%2BPulli%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=Pulli%20B&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%3ABenjamin%2BPulli%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-12"><div class="author-tooltip-name">Vaibhav Vagal </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Department of Radiology (M.K.), Cooper Medical School of Rowan University, Camden, NJ, USA; Department of Radiology (J.Y.M., H.A.S., M.S., H.L., V.S.Y), Department of Neurosurgery (R.X.), and Department of Neurology (V.C.U., E.B.M., R.L., M.B., R.H.L, A.E.H), Johns Hopkins Hospital, Baltimore, MD, USA; Department of Radiology (D.A.L.), West Virginia University Medicine, Morgantown, WV, USA; Department of Neuroradiology (A.A.D.), Massachusetts General Hospital & Harvard Medical School, Boston, MA, USA; Department of Radiology (A.G.), Universite Libre De Bruxelles Hospital, Erasme, Belgium; Department of Radiology (J.J.H., B.P.), Department of Neurology (G.W.A.), Stanford University School of Medicine, Stanford, CA, USA; Department of Radiology (D.W.), Brown University/Rhode Island Hospital, Providence, RI, USA; Department of Radiology (T.D.F.), University Medical Center Munster, Munster, Germany; Department of Radiology (V.V.), Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA; Department of Radiology (A.S.), Department of Neurology (Y.A.), University of Cincinnati, Cincinnati, OH, USA; Department of Radiology and Biomedical Imaging (K.N.), University of California San Francisco, San Francisco, CA, USA.</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=Vaibhav%2BVagal%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=Vagal%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 last"><a href="/search/author1%3AVaibhav%2BVagal%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-13"><div class="author-tooltip-name">Aakanksha Sriwastwa </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Department of Radiology (M.K.), Cooper Medical School of Rowan University, Camden, NJ, USA; Department of Radiology (J.Y.M., H.A.S., M.S., H.L., V.S.Y), Department of Neurosurgery (R.X.), and Department of Neurology (V.C.U., E.B.M., R.L., M.B., R.H.L, A.E.H), Johns Hopkins Hospital, Baltimore, MD, USA; Department of Radiology (D.A.L.), West Virginia University Medicine, Morgantown, WV, USA; Department of Neuroradiology (A.A.D.), Massachusetts General Hospital & Harvard Medical School, Boston, MA, USA; Department of Radiology (A.G.), Universite Libre De Bruxelles Hospital, Erasme, Belgium; Department of Radiology (J.J.H., B.P.), Department of Neurology (G.W.A.), Stanford University School of Medicine, Stanford, CA, USA; Department of Radiology (D.W.), Brown University/Rhode Island Hospital, Providence, RI, USA; Department of Radiology (T.D.F.), University Medical Center Munster, Munster, Germany; Department of Radiology (V.V.), Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA; Department of Radiology (A.S.), Department of Neurology (Y.A.), University of Cincinnati, Cincinnati, OH, USA; Department of Radiology and Biomedical Imaging (K.N.), University of California San Francisco, San Francisco, CA, USA.</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=Aakanksha%2BSriwastwa%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=Sriwastwa%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 last"><a href="/search/author1%3AAakanksha%2BSriwastwa%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-14"><div class="author-tooltip-name">Yasmin Aziz </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Department of Radiology (M.K.), Cooper Medical School of Rowan University, Camden, NJ, USA; Department of Radiology (J.Y.M., H.A.S., M.S., H.L., V.S.Y), Department of Neurosurgery (R.X.), and Department of Neurology (V.C.U., E.B.M., R.L., M.B., R.H.L, A.E.H), Johns Hopkins Hospital, Baltimore, MD, USA; Department of Radiology (D.A.L.), West Virginia University Medicine, Morgantown, WV, USA; Department of Neuroradiology (A.A.D.), Massachusetts General Hospital & Harvard Medical School, Boston, MA, USA; Department of Radiology (A.G.), Universite Libre De Bruxelles Hospital, Erasme, Belgium; Department of Radiology (J.J.H., B.P.), Department of Neurology (G.W.A.), Stanford University School of Medicine, Stanford, CA, USA; Department of Radiology (D.W.), Brown University/Rhode Island Hospital, Providence, RI, USA; Department of Radiology (T.D.F.), University Medical Center Munster, Munster, Germany; Department of Radiology (V.V.), Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA; Department of Radiology (A.S.), Department of Neurology (Y.A.), University of Cincinnati, Cincinnati, OH, USA; Department of Radiology and Biomedical Imaging (K.N.), University of California San Francisco, San Francisco, CA, USA.</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=Yasmin%2BAziz%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=Aziz%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 last"><a href="/search/author1%3AYasmin%2BAziz%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-15"><div class="author-tooltip-name">Risheng Xu </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Department of Radiology (M.K.), Cooper Medical School of Rowan University, Camden, NJ, USA; Department of Radiology (J.Y.M., H.A.S., M.S., H.L., V.S.Y), Department of Neurosurgery (R.X.), and Department of Neurology (V.C.U., E.B.M., R.L., M.B., R.H.L, A.E.H), Johns Hopkins Hospital, Baltimore, MD, USA; Department of Radiology (D.A.L.), West Virginia University Medicine, Morgantown, WV, USA; Department of Neuroradiology (A.A.D.), Massachusetts General Hospital & Harvard Medical School, Boston, MA, USA; Department of Radiology (A.G.), Universite Libre De Bruxelles Hospital, Erasme, Belgium; Department of Radiology (J.J.H., B.P.), Department of Neurology (G.W.A.), Stanford University School of Medicine, Stanford, CA, USA; Department of Radiology (D.W.), Brown University/Rhode Island Hospital, Providence, RI, USA; Department of Radiology (T.D.F.), University Medical Center Munster, Munster, Germany; Department of Radiology (V.V.), Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA; Department of Radiology (A.S.), Department of Neurology (Y.A.), University of Cincinnati, Cincinnati, OH, USA; Department of Radiology and Biomedical Imaging (K.N.), University of California San Francisco, San Francisco, CA, USA.</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=Risheng%2BXu%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=Xu%20R&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%3ARisheng%2BXu%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-16"><div class="author-tooltip-name">Hanzhang Lu </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Department of Radiology (M.K.), Cooper Medical School of Rowan University, Camden, NJ, USA; Department of Radiology (J.Y.M., H.A.S., M.S., H.L., V.S.Y), Department of Neurosurgery (R.X.), and Department of Neurology (V.C.U., E.B.M., R.L., M.B., R.H.L, A.E.H), Johns Hopkins Hospital, Baltimore, MD, USA; Department of Radiology (D.A.L.), West Virginia University Medicine, Morgantown, WV, USA; Department of Neuroradiology (A.A.D.), Massachusetts General Hospital & Harvard Medical School, Boston, MA, USA; Department of Radiology (A.G.), Universite Libre De Bruxelles Hospital, Erasme, Belgium; Department of Radiology (J.J.H., B.P.), Department of Neurology (G.W.A.), Stanford University School of Medicine, Stanford, CA, USA; Department of Radiology (D.W.), Brown University/Rhode Island Hospital, Providence, RI, USA; Department of Radiology (T.D.F.), University Medical Center Munster, Munster, Germany; Department of Radiology (V.V.), Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA; Department of Radiology (A.S.), Department of Neurology (Y.A.), University of Cincinnati, Cincinnati, OH, USA; Department of Radiology and Biomedical Imaging (K.N.), University of California San Francisco, San Francisco, CA, USA.</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=Hanzhang%2BLu%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=Lu%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%3AHanzhang%2BLu%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-17"><div class="author-tooltip-name">Victor C. Urrutia </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Department of Radiology (M.K.), Cooper Medical School of Rowan University, Camden, NJ, USA; Department of Radiology (J.Y.M., H.A.S., M.S., H.L., V.S.Y), Department of Neurosurgery (R.X.), and Department of Neurology (V.C.U., E.B.M., R.L., M.B., R.H.L, A.E.H), Johns Hopkins Hospital, Baltimore, MD, USA; Department of Radiology (D.A.L.), West Virginia University Medicine, Morgantown, WV, USA; Department of Neuroradiology (A.A.D.), Massachusetts General Hospital & Harvard Medical School, Boston, MA, USA; Department of Radiology (A.G.), Universite Libre De Bruxelles Hospital, Erasme, Belgium; Department of Radiology (J.J.H., B.P.), Department of Neurology (G.W.A.), Stanford University School of Medicine, Stanford, CA, USA; Department of Radiology (D.W.), Brown University/Rhode Island Hospital, Providence, RI, USA; Department of Radiology (T.D.F.), University Medical Center Munster, Munster, Germany; Department of Radiology (V.V.), Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA; Department of Radiology (A.S.), Department of Neurology (Y.A.), University of Cincinnati, Cincinnati, OH, USA; Department of Radiology and Biomedical Imaging (K.N.), University of California San Francisco, San Francisco, CA, USA.</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=Victor%2BC.%2BUrrutia%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=Urrutia%20VC&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%3AVictor%2BC.%2BUrrutia%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-18"><div class="author-tooltip-name">Elisabeth B. Marsh </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Department of Radiology (M.K.), Cooper Medical School of Rowan University, Camden, NJ, USA; Department of Radiology (J.Y.M., H.A.S., M.S., H.L., V.S.Y), Department of Neurosurgery (R.X.), and Department of Neurology (V.C.U., E.B.M., R.L., M.B., R.H.L, A.E.H), Johns Hopkins Hospital, Baltimore, MD, USA; Department of Radiology (D.A.L.), West Virginia University Medicine, Morgantown, WV, USA; Department of Neuroradiology (A.A.D.), Massachusetts General Hospital & Harvard Medical School, Boston, MA, USA; Department of Radiology (A.G.), Universite Libre De Bruxelles Hospital, Erasme, Belgium; Department of Radiology (J.J.H., B.P.), Department of Neurology (G.W.A.), Stanford University School of Medicine, Stanford, CA, USA; Department of Radiology (D.W.), Brown University/Rhode Island Hospital, Providence, RI, USA; Department of Radiology (T.D.F.), University Medical Center Munster, Munster, Germany; Department of Radiology (V.V.), Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA; Department of Radiology (A.S.), Department of Neurology (Y.A.), University of Cincinnati, Cincinnati, OH, USA; Department of Radiology and Biomedical Imaging (K.N.), University of California San Francisco, San Francisco, CA, USA.</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=Elisabeth%2BB.%2BMarsh%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=Marsh%20EB&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%3AElisabeth%2BB.%2BMarsh%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-19"><div class="author-tooltip-name">Richard Leigh </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Department of Radiology (M.K.), Cooper Medical School of Rowan University, Camden, NJ, USA; Department of Radiology (J.Y.M., H.A.S., M.S., H.L., V.S.Y), Department of Neurosurgery (R.X.), and Department of Neurology (V.C.U., E.B.M., R.L., M.B., R.H.L, A.E.H), Johns Hopkins Hospital, Baltimore, MD, USA; Department of Radiology (D.A.L.), West Virginia University Medicine, Morgantown, WV, USA; Department of Neuroradiology (A.A.D.), Massachusetts General Hospital & Harvard Medical School, Boston, MA, USA; Department of Radiology (A.G.), Universite Libre De Bruxelles Hospital, Erasme, Belgium; Department of Radiology (J.J.H., B.P.), Department of Neurology (G.W.A.), Stanford University School of Medicine, Stanford, CA, USA; Department of Radiology (D.W.), Brown University/Rhode Island Hospital, Providence, RI, USA; Department of Radiology (T.D.F.), University Medical Center Munster, Munster, Germany; Department of Radiology (V.V.), Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA; Department of Radiology (A.S.), Department of Neurology (Y.A.), University of Cincinnati, Cincinnati, OH, USA; Department of Radiology and Biomedical Imaging (K.N.), University of California San Francisco, San Francisco, CA, USA.</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=Richard%2BLeigh%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=Leigh%20R&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%3ARichard%2BLeigh%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-20"><div class="author-tooltip-name">Mona Bahouth </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Department of Radiology (M.K.), Cooper Medical School of Rowan University, Camden, NJ, USA; Department of Radiology (J.Y.M., H.A.S., M.S., H.L., V.S.Y), Department of Neurosurgery (R.X.), and Department of Neurology (V.C.U., E.B.M., R.L., M.B., R.H.L, A.E.H), Johns Hopkins Hospital, Baltimore, MD, USA; Department of Radiology (D.A.L.), West Virginia University Medicine, Morgantown, WV, USA; Department of Neuroradiology (A.A.D.), Massachusetts General Hospital & Harvard Medical School, Boston, MA, USA; Department of Radiology (A.G.), Universite Libre De Bruxelles Hospital, Erasme, Belgium; Department of Radiology (J.J.H., B.P.), Department of Neurology (G.W.A.), Stanford University School of Medicine, Stanford, CA, USA; Department of Radiology (D.W.), Brown University/Rhode Island Hospital, Providence, RI, USA; Department of Radiology (T.D.F.), University Medical Center Munster, Munster, Germany; Department of Radiology (V.V.), Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA; Department of Radiology (A.S.), Department of Neurology (Y.A.), University of Cincinnati, Cincinnati, OH, USA; Department of Radiology and Biomedical Imaging (K.N.), University of California San Francisco, San Francisco, CA, USA.</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=Mona%2BBahouth%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=Bahouth%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 last"><a href="/search/author1%3AMona%2BBahouth%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-21"><div class="author-tooltip-name">Rafael H. Llinas </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Department of Radiology (M.K.), Cooper Medical School of Rowan University, Camden, NJ, USA; Department of Radiology (J.Y.M., H.A.S., M.S., H.L., V.S.Y), Department of Neurosurgery (R.X.), and Department of Neurology (V.C.U., E.B.M., R.L., M.B., R.H.L, A.E.H), Johns Hopkins Hospital, Baltimore, MD, USA; Department of Radiology (D.A.L.), West Virginia University Medicine, Morgantown, WV, USA; Department of Neuroradiology (A.A.D.), Massachusetts General Hospital & Harvard Medical School, Boston, MA, USA; Department of Radiology (A.G.), Universite Libre De Bruxelles Hospital, Erasme, Belgium; Department of Radiology (J.J.H., B.P.), Department of Neurology (G.W.A.), Stanford University School of Medicine, Stanford, CA, USA; Department of Radiology (D.W.), Brown University/Rhode Island Hospital, Providence, RI, USA; Department of Radiology (T.D.F.), University Medical Center Munster, Munster, Germany; Department of Radiology (V.V.), Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA; Department of Radiology (A.S.), Department of Neurology (Y.A.), University of Cincinnati, Cincinnati, OH, USA; Department of Radiology and Biomedical Imaging (K.N.), University of California San Francisco, San Francisco, CA, USA.</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=Rafael%2BH.%2BLlinas%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=Llinas%20RH&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%3ARafael%2BH.%2BLlinas%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-22"><div class="author-tooltip-name">Kambiz Nael </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Department of Radiology (M.K.), Cooper Medical School of Rowan University, Camden, NJ, USA; Department of Radiology (J.Y.M., H.A.S., M.S., H.L., V.S.Y), Department of Neurosurgery (R.X.), and Department of Neurology (V.C.U., E.B.M., R.L., M.B., R.H.L, A.E.H), Johns Hopkins Hospital, Baltimore, MD, USA; Department of Radiology (D.A.L.), West Virginia University Medicine, Morgantown, WV, USA; Department of Neuroradiology (A.A.D.), Massachusetts General Hospital & Harvard Medical School, Boston, MA, USA; Department of Radiology (A.G.), Universite Libre De Bruxelles Hospital, Erasme, Belgium; Department of Radiology (J.J.H., B.P.), Department of Neurology (G.W.A.), Stanford University School of Medicine, Stanford, CA, USA; Department of Radiology (D.W.), Brown University/Rhode Island Hospital, Providence, RI, USA; Department of Radiology (T.D.F.), University Medical Center Munster, Munster, Germany; Department of Radiology (V.V.), Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA; Department of Radiology (A.S.), Department of Neurology (Y.A.), University of Cincinnati, Cincinnati, OH, USA; Department of Radiology and Biomedical Imaging (K.N.), University of California San Francisco, San Francisco, CA, USA.</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=Kambiz%2BNael%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=Nael%20K&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%3AKambiz%2BNael%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-23"><div class="author-tooltip-name">ArgyeE. Hillis </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Department of Radiology (M.K.), Cooper Medical School of Rowan University, Camden, NJ, USA; Department of Radiology (J.Y.M., H.A.S., M.S., H.L., V.S.Y), Department of Neurosurgery (R.X.), and Department of Neurology (V.C.U., E.B.M., R.L., M.B., R.H.L, A.E.H), Johns Hopkins Hospital, Baltimore, MD, USA; Department of Radiology (D.A.L.), West Virginia University Medicine, Morgantown, WV, USA; Department of Neuroradiology (A.A.D.), Massachusetts General Hospital & Harvard Medical School, Boston, MA, USA; Department of Radiology (A.G.), Universite Libre De Bruxelles Hospital, Erasme, Belgium; Department of Radiology (J.J.H., B.P.), Department of Neurology (G.W.A.), Stanford University School of Medicine, Stanford, CA, USA; Department of Radiology (D.W.), Brown University/Rhode Island Hospital, Providence, RI, USA; Department of Radiology (T.D.F.), University Medical Center Munster, Munster, Germany; Department of Radiology (V.V.), Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA; Department of Radiology (A.S.), Department of Neurology (Y.A.), University of Cincinnati, Cincinnati, OH, USA; Department of Radiology and Biomedical Imaging (K.N.), University of California San Francisco, San Francisco, CA, USA.</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=ArgyeE.%2BHillis%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=Hillis%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 last"><a href="/search/author1%3AArgyeE.%2BHillis%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-24"><div class="author-tooltip-name">Vivek S. Yedavalli </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Department of Radiology (M.K.), Cooper Medical School of Rowan University, Camden, NJ, USA; Department of Radiology (J.Y.M., H.A.S., M.S., H.L., V.S.Y), Department of Neurosurgery (R.X.), and Department of Neurology (V.C.U., E.B.M., R.L., M.B., R.H.L, A.E.H), Johns Hopkins Hospital, Baltimore, MD, USA; Department of Radiology (D.A.L.), West Virginia University Medicine, Morgantown, WV, USA; Department of Neuroradiology (A.A.D.), Massachusetts General Hospital & Harvard Medical School, Boston, MA, USA; Department of Radiology (A.G.), Universite Libre De Bruxelles Hospital, Erasme, Belgium; Department of Radiology (J.J.H., B.P.), Department of Neurology (G.W.A.), Stanford University School of Medicine, Stanford, CA, USA; Department of Radiology (D.W.), Brown University/Rhode Island Hospital, Providence, RI, USA; Department of Radiology (T.D.F.), University Medical Center Munster, Munster, Germany; Department of Radiology (V.V.), Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA; Department of Radiology (A.S.), Department of Neurology (Y.A.), University of Cincinnati, Cincinnati, OH, USA; Department of Radiology and Biomedical Imaging (K.N.), University of California San Francisco, San Francisco, CA, USA.</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=Vivek%2BS.%2BYedavalli%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=Yedavalli%20VS&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%3AVivek%2BS.%2BYedavalli%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div></div></div>  </div>

  
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    <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" data-highwire-cite-ref-tooltip-instance="highwire_reflinks_tooltip" class="content-block-markup" xmlns:xhtml="http://www.w3.org/1999/xhtml"><div class="article abstract-view "><span class="highwire-journal-article-marker-start"></span><div class="section abstract" id="abstract-1"><h2 class="">ABSTRACT</h2><div id="sec-1" class="subsection"><p id="p-1"><strong>BACKGROUND AND PURPOSE:</strong> Prolonged venous transit (PVT+) is a marker of venous outflow; it is defined as the presence or absence of time-to-maximum ≥10 seconds timing in either the superior sagittal sinus or torcula. This novel perfusion imaging-based metric has been associated with higher odds of mortality and lower odds of functional recovery. This study aims to assess the relationship between PVT on admission perfusion imaging and length of hospital stay in large vessel occlusion strokes successfully reperfused with mechanical thrombectomy.</p></div><div id="sec-2" class="subsection"><p id="p-2"><strong>MATERIALS AND METHODS:</strong> Acute ischemic stroke patients with large vessel occlusions in the anterior circulation successfully treated with thrombectomy between 01/2017 and 09/2022 were retrospectively reviewed. The primary outcome was length of stay in the hospital due to the acute stroke event. Univariable and forward stepwise multivariable linear regressions were performed for the primary outcome.</p></div><div id="sec-3" class="subsection"><p id="p-3"><strong>RESULTS:</strong> Of 109 patients meeting inclusion, median age was 71 (interquartile range [IQR] 62-80) years. Median hospital length of stay was significantly greater in PVT+ patients (9 [IQR 6-18] days) compared to PVT-patients (6 [IQR 4-12] days, p=0.03). In multivariable regression, PVT+ was significantly associated with length of stay, and PVT+ was associated with approximately two additional days of hospital stay compared to PVT-(p=0.03).</p></div><div id="sec-4" class="subsection"><p id="p-4"><strong>CONCLUSIONS:</strong> In successfully reperfused large vessel occlusion strokes, PVT+ was associated with an additional two days of hospital stay on average compared to PVT-patients, when adjusting for other clinical covariables. This simple, novel imaging metric is robust in correlating with a range of short and long term clinical outcomes.</p><p id="p-5">ABBREVIATIONS: VO = venous outflow; Tmax = time-to-maximum; PVT = prolonged venous transit; AIS-LVO = large vessel occlusion ischemic stroke; SSS = superior sagittal sinus; rCBF = relative cerebral blood flow; IQR = interquartile range; VIF = variance inflation factor.</p></div></div><ul class="copyright-statement"><li class="fn" id="copyright-statement-1">© 2024 by American Journal of Neuroradiology</li></ul><span class="highwire-journal-article-marker-end"></span></div><span class="related-urls"></span></div></div>  </div>

  
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      <div class="highwire-cite-title">Prolonged Venous Transit on Perfusion Imaging is Associated with Longer Lengths of Stay in Acute Large Vessel Occlusions</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">Manisha</span> <span class="nlm-surname">Koneru</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">Janet Y.</span> <span class="nlm-surname">Mei</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">Dhairya A.</span> <span class="nlm-surname">Lakhani</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">Hamza A.</span> <span class="nlm-surname">Salim</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">Mona</span> <span class="nlm-surname">Shahriari</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">Adam A.</span> <span class="nlm-surname">Dmytriw</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">Adrien</span> <span class="nlm-surname">Guenego</span></span>, <span class="highwire-citation-author" data-delta="7"><span class="nlm-given-names">Jeremy J.</span> <span class="nlm-surname">Heit</span></span>, <span class="highwire-citation-author" data-delta="8"><span class="nlm-given-names">Gregory W.</span> <span class="nlm-surname">Albers</span></span>, <span class="highwire-citation-author" data-delta="9"><span class="nlm-given-names">Dylan</span> <span class="nlm-surname">Wolman</span></span>, <span class="highwire-citation-author" data-delta="10"><span class="nlm-given-names">Tobias D.</span> <span class="nlm-surname">Faizy</span></span>, <span class="highwire-citation-author" data-delta="11"><span class="nlm-given-names">Benjamin</span> <span class="nlm-surname">Pulli</span></span>, <span class="highwire-citation-author" data-delta="12"><span class="nlm-given-names">Vaibhav</span> <span class="nlm-surname">Vagal</span></span>, <span class="highwire-citation-author" data-delta="13"><span class="nlm-given-names">Aakanksha</span> <span class="nlm-surname">Sriwastwa</span></span>, <span class="highwire-citation-author" data-delta="14"><span class="nlm-given-names">Yasmin</span> <span class="nlm-surname">Aziz</span></span>, <span class="highwire-citation-author" data-delta="15"><span class="nlm-given-names">Risheng</span> <span class="nlm-surname">Xu</span></span>, <span class="highwire-citation-author" data-delta="16"><span class="nlm-given-names">Hanzhang</span> <span class="nlm-surname">Lu</span></span>, <span class="highwire-citation-author" data-delta="17"><span class="nlm-given-names">Victor C.</span> <span class="nlm-surname">Urrutia</span></span>, <span class="highwire-citation-author" data-delta="18"><span class="nlm-given-names">Elisabeth B.</span> <span class="nlm-surname">Marsh</span></span>, <span class="highwire-citation-author" data-delta="19"><span class="nlm-given-names">Richard</span> <span class="nlm-surname">Leigh</span></span>, <span class="highwire-citation-author" data-delta="20"><span class="nlm-given-names">Mona</span> <span class="nlm-surname">Bahouth</span></span>, <span class="highwire-citation-author" data-delta="21"><span class="nlm-given-names">Rafael H.</span> <span class="nlm-surname">Llinas</span></span>, <span class="highwire-citation-author" data-delta="22"><span class="nlm-given-names">Kambiz</span> <span class="nlm-surname">Nael</span></span>, <span class="highwire-citation-author" data-delta="23"><span class="nlm-given-names">ArgyeE.</span> <span class="nlm-surname">Hillis</span></span>, <span class="highwire-citation-author" data-delta="24"><span class="nlm-given-names">Vivek S.</span> <span class="nlm-surname">Yedavalli</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-pages highwire-cite-metadata">ajnr.A8611; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A8611 </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">Manisha</span> <span class="nlm-surname">Koneru</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">Janet Y.</span> <span class="nlm-surname">Mei</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">Dhairya A.</span> <span class="nlm-surname">Lakhani</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">Hamza A.</span> <span class="nlm-surname">Salim</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">Mona</span> <span class="nlm-surname">Shahriari</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">Adam A.</span> <span class="nlm-surname">Dmytriw</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">Adrien</span> <span class="nlm-surname">Guenego</span></span>, <span class="highwire-citation-author" data-delta="7"><span class="nlm-given-names">Jeremy J.</span> <span class="nlm-surname">Heit</span></span>, <span class="highwire-citation-author" data-delta="8"><span class="nlm-given-names">Gregory W.</span> <span class="nlm-surname">Albers</span></span>, <span class="highwire-citation-author" data-delta="9"><span class="nlm-given-names">Dylan</span> <span class="nlm-surname">Wolman</span></span>, <span class="highwire-citation-author" data-delta="10"><span class="nlm-given-names">Tobias D.</span> <span class="nlm-surname">Faizy</span></span>, <span class="highwire-citation-author" data-delta="11"><span class="nlm-given-names">Benjamin</span> <span class="nlm-surname">Pulli</span></span>, <span class="highwire-citation-author" data-delta="12"><span class="nlm-given-names">Vaibhav</span> <span class="nlm-surname">Vagal</span></span>, <span class="highwire-citation-author" data-delta="13"><span class="nlm-given-names">Aakanksha</span> <span class="nlm-surname">Sriwastwa</span></span>, <span class="highwire-citation-author" data-delta="14"><span class="nlm-given-names">Yasmin</span> <span class="nlm-surname">Aziz</span></span>, <span class="highwire-citation-author" data-delta="15"><span class="nlm-given-names">Risheng</span> <span class="nlm-surname">Xu</span></span>, <span class="highwire-citation-author" data-delta="16"><span class="nlm-given-names">Hanzhang</span> <span class="nlm-surname">Lu</span></span>, <span class="highwire-citation-author" data-delta="17"><span class="nlm-given-names">Victor C.</span> <span class="nlm-surname">Urrutia</span></span>, <span class="highwire-citation-author" data-delta="18"><span class="nlm-given-names">Elisabeth B.</span> <span class="nlm-surname">Marsh</span></span>, <span class="highwire-citation-author" data-delta="19"><span class="nlm-given-names">Richard</span> <span class="nlm-surname">Leigh</span></span>, <span class="highwire-citation-author" data-delta="20"><span class="nlm-given-names">Mona</span> <span class="nlm-surname">Bahouth</span></span>, <span class="highwire-citation-author" data-delta="21"><span class="nlm-given-names">Rafael H.</span> <span class="nlm-surname">Llinas</span></span>, <span class="highwire-citation-author" data-delta="22"><span class="nlm-given-names">Kambiz</span> <span class="nlm-surname">Nael</span></span>, <span class="highwire-citation-author" data-delta="23"><span class="nlm-given-names">ArgyeE.</span> <span class="nlm-surname">Hillis</span></span>, <span class="highwire-citation-author" data-delta="24"><span class="nlm-given-names">Vivek S.</span> <span class="nlm-surname">Yedavalli</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-pages highwire-cite-metadata">ajnr.A8611; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A8611 </span></div>
  
  
  
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