Abstract TP174: Prolonged Venous Transit Independently Predicts Worse Functional Outcomes at Discharge in Successfully Reperfused Patients with Large Vessel Occlusion Stroke
Bibliographic record
Abstract
Background and Purpose: Venous outflow (VO) impairment predicts unfavorable outcomes in patients with acute ischemic stroke caused by large vessel occlusion (AIS-LVO). Prolonged venous transit (PVT), a visual qualitative VO marker on CT perfusion (CTP) time to maximum (Tmax) maps, has been associated with 90-day mortality despite successful reperfusion. This study investigates the association between PVT and modified Rankin Scale (mRS) score at discharge among AIS-LVO patients who have undergone successful reperfusion. Methods: We performed a retrospective analysis of prospectively collected data from consecutive adult AIS-LVO patients with successful reperfusion (modified Thrombolysis in Cerebral Infarction 2b/2c/3). PVT+ was defined as Tmax ≥10s in at least one of the following locations: superior sagittal sinus and/or torcula. The primary outcome was dichotomous mRS scores at discharge (favorable: mRS 0-2; unfavorable: mRS 3-6). Regression analyses were performed to assess the effect of PVT on discharge mRS. Results: In 119 patients of median (IQR) age 71 (63-81) years, a significantly higher proportion of PVT+ patients exhibited unfavorable mRS scores compared to PVT- patients (88.8% vs. 62.7%, p=0.004). After adjusting for age, sex, hypertension, hyperlipidemia, diabetes, atrial fibrillation, history of stroke or transient ischemic attack (TIA), tobacco use, administration of intravenous thrombolysis (IVT), admission National Institutes of Health Stroke Scale (NIHSS), Alberta Stroke Program Early CT (ASPECTS) score, and ischemic core volume, the PVT+ remains significantly associated with unfavorable mRS (OR=0.215, 95%CI 0.048-0.959, p=0.044). Conclusions: PVT+ was significantly associated with unfavorable mRS at discharge despite successful reperfusion in AIS-LVO patients, underscoring the importance of VO impairment in short-term functional outcomes. PVT serves as a valuable adjunct imaging biomarker derived from CTP for assessing VO profiles in AIS-LVO.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".