Prolonged Venous Transit as a Superior Predictor of Functional Outcomes in Successfully Reperfused Large Vessel Occlusions: Comparative Analysis With Cerebral Blood Volume Index and Hypoperfusion Intensity Ratio

Q: What are the key findings of this study?

Prolonged venous transit (PVT) was a superior predictor of 90-day functional outcomes compared with cerebral blood volume index and hypoperfusion intensity ratio.

Q: What is the clinical evidence from this study?

Study design: Observational. Population: Acute ischemic stroke due to large vessel occlusion. Intervention: Prolonged venous transit (PVT) vs. Cerebral blood volume index and hypoperfusion intensity ratio. Primary outcome: 90-day functional outcomes (p=<0.05).

Q: What question did this study set out to answer?

To compare the prognostic performance of prolonged venous transit (PVT), cerebral blood volume index, and hypoperfusion intensity ratio for predicting 90-day functional outcomes in acute ischemic stroke patients with large vessel occlusions who achieved successful reperfusion.

Janet Mei; Hamza Salim; Dhairya A. Lakhani; Aneri Balar; Vaibhav Vagal; Manisha Koneru; Dylan Wolman; Risheng Xu; Victor Urrutia; Elisabeth B. Marsh; Benjamin Pulli; Meisam Hoseinyazdi; Licia Luna; Francis Deng; Nathan Hyson; Mona Shahriari; Adam A. Dmytriw; Adrien Guenego; Gregory W. Albers; Hanzhang Lu; Kambiz Nael; Argye E. Hillis; R. Llinás; Max Wintermark; Tobias D. Faizy; Jeremy J. Heit; Vivek Yedavalli

doi:10.1161/jaha.124.039924

Key result

PVT outperforms CBV index and hypoperfusion intensity ratio for predicting 90-day functional outcomes.

P<0.05

Why the study?

Does prolonged venous transit (PVT) better predict 90-day functional outcomes compared to cerebral blood volume index and hypoperfusion intensity ratio in patients with acute ischemic stroke following mechanical thrombectomy?

Key Points

To compare the prognostic performance of prolonged venous transit (PVT), cerebral blood volume index, and hypoperfusion intensity ratio for predicting 90-day functional outcomes in acute ischemic stroke patients with large vessel occlusions who achieved successful reperfusion.
Evaluated patients with large vessel occlusion stroke who underwent successful reperfusion following mechanical thrombectomy.
Assessed collateral status and microvascular circulation using prolonged venous transit, cerebral blood volume index, and hypoperfusion intensity ratio in relation to 90-day functional outcomes.
Prolonged venous transit was statistically significant (P < 0.05) and showed superior predictive performance for 90-day functional outcomes compared with cerebral blood volume index and hypoperfusion intensity ratio.
Venous outflow dynamics strongly correlated with collateral efficacy and long-term recovery following successful arterial recanalization.

Study Design

Type

Observational

Structured PICO

Does prolonged venous transit (PVT) better predict 90-day functional outcomes compared to cerebral blood volume index and hypoperfusion intensity ratio in patients with acute ischemic stroke following mechanical thrombectomy?

P

Population

Patients with acute ischemic stroke due to large vessel occlusion following mechanical thrombectomy

E

Exposure

Prolonged venous transit (PVT) assessment

C

Comparator

Cerebral blood volume index and hypoperfusion intensity ratio

O

Outcome

90-day functional outcomeshard clinical

Main Result

p-value: p=<0.05

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Implication

Prolonged venous transit is a superior predictor of 90-day functional outcomes compared to other perfusion metrics in patients with large vessel occlusion stroke after thrombectomy.

Abstract

BACKGROUND: Collateral status plays a crucial role in outcomes after acute ischemic stroke due to large vessel occlusion. Tissue-level collaterals and venous outflow are key components following mechanical thrombectomy. This study evaluates the predictive performance of prolonged venous transit (PVT), cerebral blood volume index, and hypoperfusion intensity ratio in determining 90-day functional outcomes. METHODS AND CONCLUSIONS: PVT is a superior predictor of 90-day functional outcomes compared with cerebral blood volume index and hypoperfusion intensity ratio, emphasizing the role of venous outflow in collateral assessment and stroke prognosis.

Discussion

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Cite This Study

Mei et al. (2025) conducted an observational in Acute ischemic stroke due to large vessel occlusion. Prolonged venous transit (PVT) vs. Cerebral blood volume index and hypoperfusion intensity ratio was evaluated on 90-day functional outcomes (p=<0.05). Prolonged venous transit (PVT) was a superior predictor of 90-day functional outcomes compared with cerebral blood volume index and hypoperfusion intensity ratio.

synapsesocial.com/papers/6a00c695b124fe5819860b13 https://doi.org/10.1161/jaha.124.039924

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Prolonged Venous Transit as a Superior Predictor of Functional Outcomes in Successfully Reperfused Large Vessel Occlusions: Comparative Analysis With Cerebral Blood Volume Index and Hypoperfusion Intensity Ratio

Key Points

Study Design

Structured PICO

Main Result

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Prolonged Venous Transit as a Superior Predictor of Functional Outcomes in Successfully Reperfused Large Vessel Occlusions: Comparative Analysis With Cerebral Blood Volume Index and Hypoperfusion Intensity Ratio

Key Points

Study Design

Structured PICO

Main Result

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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