Magnetic resonance imaging and clinical prediction of intracranial atherosclerotic large vessel occlusion in acute ischemic stroke treated with endovascular thrombectomy - Report - MDSpire

Magnetic resonance imaging and clinical prediction of intracranial atherosclerotic large vessel occlusion in acute ischemic stroke treated with endovascular thrombectomy

  • By

  • Yohei Tateishi

  • Hiroaki Otsuka

  • Aya Yamashita

  • Keiichiro Onizuka

  • Takanori Amano

  • Daiji Torimura

  • Yuki Tomita

  • Takuro Hirayama

  • Tomoaki Shima

  • Shunsuke Yoshimura

  • Teiichiro Miyazaki

  • Yuki Matsunaga

  • Hajime Maeda

  • Akira Tsujino

  • May 22, 2026

  • 0 min

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Clinical Report: Utilizing MRI for Predicting ICAS-LVO in Stroke Patients

Overview

This study developed an MRI- and clinical-based score to predict intracranial atherosclerotic large vessel occlusion (ICAS-LVO) in acute ischemic stroke patients undergoing endovascular thrombectomy. The ICAS-M score demonstrated high discrimination for ICAS-LVO.

Background

Intracranial atherosclerosis is a leading cause of acute ischemic stroke, particularly in certain populations. Identifying ICAS-LVO early is crucial. Current imaging techniques may not fully address the need for timely and accurate predictions of ICAS-LVO.

Data Highlights

VariableOdds Ratio (OR)95% Confidence Interval (CI)p-value
Absence of atrial fibrillation20.146.02–89.89< 0.001
Multiple cortical/border-zone infarcts10.963.65–34.90< 0.001
Mixed acute–subacute lesions5.101.51–17.840.009
Absence of susceptibility vessel sign4.631.81–12.510.002

Key Findings

  • 44 out of 335 patients (13%) had ICAS-LVO.
  • The ICAS-M score showed an AUC of 0.940 for ICAS-LVO discrimination.
  • Absence of atrial fibrillation was the strongest predictor of ICAS-LVO.
  • Multiple cortical/border-zone infarcts significantly increased the odds of ICAS-LVO.

Clinical Implications

The ICAS-M score can assist clinicians in rapidly identifying patients with ICAS-LVO, potentially leading to tailored endovascular strategies. This predictive model may enhance decision-making in acute stroke management.

Conclusion

The study presents a promising MRI-based predictive model for ICAS-LVO, which may facilitate improved treatment planning in acute ischemic stroke patients undergoing endovascular thrombectomy.

Related Resources & Content

  1. Frontiers in Neurology, 2026 -- Magnetic Resonance Imaging and Clinical Prediction of Intracranial Atherosclerotic Large Vessel Occlusion in Acute Ischemic Stroke Treated with Endovascular Thrombectomy
  2. Brain — Prediction of tissue and clinical thrombectomy outcome in acute ischaemic stroke using deep learning
  3. Frontiers in Neurology — Clinical multidimensional prediction model for futile reperfusion in acute ischemic stroke after endovascular thrombectomy
  4. European Radiology — Baseline CT Imaging of Cortical Atrophy as a Predictor of Clinical Outcomes in Acute Ischemic Stroke Patients Undergoing Endovascular Therapy
  5. Frontiers in Neurology — Preoperative multimodal CT for selection of acute anterior circulation occlusion stroke patients for mechanical thrombectomy
  6. 2026 Guideline for the Early Management of Patients With Acute Ischemic Stroke
  7. Endovascular thrombectomy for large ischemic strokes: meta-analysis of six multicenter randomized controlled trials
  8. Frontiers | Magnetic Resonance Imaging and Clinical Prediction of Intracranial Atherosclerotic Large Vessel Occlusion in Acute Ischemic Stroke Treated with Endovascular Thrombectomy

Original Source(s)

Magnetic resonance imaging and clinical prediction of intracranial atherosclerotic large vessel occlusion in acute ischemic stroke treated with endovascular thrombectomy

  • by Yohei Tateishi, Hiroaki Otsuka, Aya Yamashita, Keiichiro Onizuka, Takanori Amano, Daiji Torimura, Yuki Tomita, Takuro Hirayama, Tomoaki Shima, Shunsuke Yoshimura, Teiichiro Miyazaki, Yuki Matsunaga, Hajime Maeda, Akira Tsujino

  • May 22, 2026

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