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

To develop a simple MRI- and clinical-based predictive score for ICAS-LVOs that combines readily assessable lesion patterns with key clinical characteristics in patients treated with endovascular thrombectomy.

Key Findings:
  • Among 335 eligible patients, 44 (13%) had ICAS-LVO.
  • Independent predictors of ICAS-LVO included absence of atrial fibrillation (OR 20.14; 95% CI 6.02–89.89), multiple cortical/border-zone infarcts (OR 10.96; 95% CI 3.65–34.90), mixed acute–subacute lesions (OR 5.10; 95% CI 1.51–17.84), and absence of a susceptibility vessel sign (OR 4.63; 95% CI 1.81–12.51).
  • The ICAS-M score demonstrated high discrimination for ICAS-LVOs with an AUC of 0.940.
Interpretation:

The ICAS-M score demonstrated high discrimination for ICAS-LVOs in a single-center cohort.

Limitations:
  • Single-center study may limit generalizability.
  • Retrospective design may introduce selection bias.
Conclusion:

The ICAS-M score showed high, internally validated discrimination for ICAS-LVO in a single-center cohort.

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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