Prolonged Venous Transit Is Associated with Unfavorable Functional Outcomes in Large-Core Stroke
Bibliographic record
Abstract
BACKGROUND AND PURPOSE: Large-core acute ischemic stroke caused by large-vessel occlusion (LVO) is associated with high rates of disability despite mechanical thrombectomy. Prolonged venous transit (PVT), a marker of impaired venous drainage on CTP, has emerged as a potential prognostic indicator, but its role in large-core acute ischemic stroke (AIS)-LVO remains unclear. We aimed to test the hypothesis that PVT is independently associated with unfavorable functional outcomes in patients with large-core AIS-LVO. MATERIALS AND METHODS: We conducted a retrospective cohort study using data from consecutive patients with AIS-LVO and large ischemic core volumes (ASPECTS <6 or relative CBF (rCBF)<30% volume ≥50 mL; per the SELECT-2 trial definition) between September 1, 2016, and September 2, 2024. PVT was assessed on pretreatment CTP based on qualitative time-to-maximum maps and was defined as time-to-maximum ≥10 seconds in the superior sagittal sinus or torcula. The primary outcome was unfavorable functional recovery at 90 days, defined as an mRS score of 4-6. RESULTS: = .032). CONCLUSIONS: PVT is independently associated with unfavorable outcomes in patients with large core AIS-LVO. These findings suggest that PVT may serve as a prognostic marker, warranting further investigation and validation in larger prospective studies to guide treatment decisions in this high-risk population.
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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 | 0.001 |
| 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) | 0.002 | 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".