PT - JOURNAL ARTICLE AU - Anna M M Boers AU - Ivo G H Jansen AU - Ludo F M Beenen AU - Thomas G Devlin AU - Luis San Roman AU - Ji Hoe Heo AU - Marc Ribó AU - Scott Brown AU - Mohammed A Almekhlafi AU - David S Liebeskind AU - Jeanne Teitelbaum AU - Hester F Lingsma AU - Wim H van Zwam AU - Patricia Cuadras AU - Richard du Mesnil de Rochemont AU - Marine Beaumont AU - Martin M Brown AU - Albert J Yoo AU - Robert J van Oostenbrugge AU - Bijoy K Menon AU - Geoffrey A Donnan AU - Jean Louis Mas AU - Yvo B W E M Roos AU - Catherine Oppenheim AU - Aad van der Lugt AU - Richard J Dowling AU - Michael D Hill AU - Antoni Davalos AU - Thierry Moulin AU - Nelly Agrinier AU - Andrew M Demchuk AU - Demetrius K Lopes AU - Lucia Aja Rodríguez AU - Diederik W J Dippel AU - Bruce C V Campbell AU - Peter J Mitchell AU - Fahad S Al-Ajlan AU - Tudor G Jovin AU - Jeremy Madigan AU - Gregory W Albers AU - Sebastien Soize AU - Francis Guillemin AU - Vivek K Reddy AU - Serge Bracard AU - Jordi Blasco AU - Keith W Muir AU - Raul G Nogueira AU - Phil M White AU - Mayank Goyal AU - Stephen M Davis AU - Henk A Marquering AU - Charles B L M Majoie TI - Association of follow-up infarct volume with functional outcome in acute ischemic stroke: a pooled analysis of seven randomized trials AID - 10.1136/neurintsurg-2017-013724 DP - 2018 Dec 01 TA - Journal of NeuroInterventional Surgery PG - 1137--1142 VI - 10 IP - 12 4099 - http://jnis.bmj.com/content/10/12/1137.short 4100 - http://jnis.bmj.com/content/10/12/1137.full SO - J NeuroIntervent Surg2018 Dec 01; 10 AB - Background Follow-up infarct volume (FIV) has been recommended as an early indicator of treatment efficacy in patients with acute ischemic stroke. Questions remain about the optimal imaging approach for FIV measurement.Objective To examine the association of FIV with 90-day modified Rankin Scale (mRS) score and investigate its dependency on acquisition time and modality.Methods Data of seven trials were pooled. FIV was assessed on follow-up (12 hours to 2 weeks) CT or MRI. Infarct location was defined as laterality and involvement of the Alberta Stroke Program Early CT Score regions. Relative quality and strength of multivariable regression models of the association between FIV and functional outcome were assessed. Dependency of imaging modality and acquisition time (≤48 hours vs >48 hours) was evaluated.Results Of 1665 included patients, 83% were imaged with CT. Median FIV was 41 mL (IQR 14–120). A large FIV was associated with worse functional outcome (OR=0.88(95% CI 0.87 to 0.89) per 10 mL) in adjusted analysis. A model including FIV, location, and hemorrhage type best predicted mRS score. FIV of ≥133 mL was highly specific for unfavorable outcome. FIV was equally strongly associated with mRS score for assessment on CT and MRI, even though large differences in volume were present (48 mL (IQR 15–131) vs 22 mL (IQR 8–71), respectively). Associations of both early and late FIV assessments with outcome were similar in strength (ρ=0.60(95% CI 0.56 to 0.64) and ρ=0.55(95% CI 0.50 to 0.60), respectively).Conclusions In patients with an acute ischemic stroke due to a proximal intracranial occlusion of the anterior circulation, FIV is a strong independent predictor of functional outcome and can be assessed before 48 hours, oneither CT or MRI.