{
  "abstract": "Objective\n\nTo evaluate whether pre-treatment dual-phase computed tomography angiography (CTA) filling patterns are independently associated with reperfusion-related complications after late-window mechanical thrombectomy and whether they provide incremental prognostic value beyond conventional clinical and imaging variables.Methods\n\nWe conducted a prospective single-center cohort study including 80 consecutive patients with anterior circulation large-vessel occlusion who underwent mechanical thrombectomy within 6-24 h after stroke onset or last known well. Dual-phase CTA filling patterns were classified as good early filling, delayed filling, or persistent poor filling; delayed and persistent poor filling were combined for the primary analyses. The primary outcome was a composite of reperfusion-related complications within 72 h, including hemorrhagic transformation ≥HI2, malignant cerebral edema, or early neurological deterioration. Secondary outcomes were 90-day functional independence and all-cause mortality. Independent predictors were identified using Firth penalized logistic regression. Incremental model performance was evaluated using receiver operating characteristic analysis, bootstrap internal validation, reclassification metrics, and decision-curve analysis.Results\n\nReperfusion-related complications occurred in 28 patients (35%) and were significantly more frequent in patients with delayed or poor filling than in those with good early filling (56% vs. 20%; p < 0.001). Delayed or poor filling independently predicted reperfusion-related complications after adjustment for age, baseline NIHSS score, and ASPECTS (adjusted OR 3.97, 95% CI 1.22-14.10; p = 0.022). Older age was also independently associated with increased risk (adjusted OR 2.14 per 10-year increase, 95% CI 1.24-4.12; p = 0.005), whereas higher ASPECTS was protective (adjusted OR 0.35 per point, 95% CI 0.18-0.61; p < 0.001). The full model incorporating dual-phase CTA achieved excellent discrimination (AUC 0.895; optimism-corrected AUC 0.867). Addition of the dual-phase CTA filling pattern improved patient risk reclassification, although the increase in discrimination beyond the clinical-plus-ASPECTS model was not statistically significant. Patients with delayed or poor filling had substantially worse 90-day outcomes, including lower functional independence (24% vs. 70%) and higher mortality (38% vs. 4%) (both p < 0.001).Conclusions\n\nDelayed or persistent poor filling on dual-phase CTA is an independent imaging marker of reperfusion-related complications following late-window mechanical thrombectomy. Although its incremental contribution to model discrimination was modest, dual-phase CTA may improve early risk stratification and help identify patients who may benefit from intensified post-procedural monitoring. External validation is warranted before routine clinical implementation.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Neurovascular Intervention, Institute of Neurology, 108 Military Central Hospital, Hanoi, Vietnam.",
    "Department of Stroke, Institute of Neurology, 108 Military Central Hospital, Hanoi, Vietnam."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 4,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Truong Van Le"
    },
    {
      "affs": [
        1
      ],
      "name": "Khanh T Ngoc Thach",
      "orcid": "0000-0001-8319-5744"
    },
    {
      "affs": [
        0
      ],
      "name": "Tuyen Trong Nguyen"
    },
    {
      "affs": [
        1
      ],
      "name": "Ha Hai T Dinh"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/3vev53v105zq9.bib",
  "cited_by": 0,
  "doi": "10.3389/fmed.2026.1934591",
  "fulltext_url": "https://europepmc.org/articles/PMC13683744",
  "id": "3vev53v105zq9",
  "issns": [
    "2296-858X"
  ],
  "landing_url": "https://europepmc.org/article/MED/42909051",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2713|Acute Ischemic Stroke Management"
    ]
  ],
  "openalex": "W7220830622",
  "pdf_url": "https://europepmc.org/articles/PMC13683744?pdf=render",
  "pmcid": "PMC13683744",
  "pmid": "42909051",
  "published": "2026-10-07",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/3vev53v105zq9.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:10Z",
      "native_id": "MED:42909051",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42909051"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2713|Acute Ischemic Stroke Management",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "Dual-phase CTA filling pattern is associated with reperfusion-related complications after mechanical thrombectomy in late-window anterior circulation stroke.",
  "title_text": "Dual-phase CTA filling pattern is associated with reperfusion-related complications after mechanical thrombectomy in late-window anterior circulation stroke.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:20:10Z",
  "url": "https://research.draconitic.com/paper/3vev53v105zq9",
  "venue": "Frontiers in medicine",
  "versions": []
}