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March 7, 2026American Journal of Neuroradiology0 citationsOpen Access

Gradation of Prolonged Venous Transit on Perfusion Imaging Highlights the Association of Deep Venous Drainage Impairment with Unfavorable Functional Outcome in Successfully Reperfused Anterior Circulation Large-Vessel-Occlusion Stroke

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JMJanet MeiBMBasel MusmarDLDhairya A. Lakhani

Key Points

  • This research examines the relationship between venous drainage impairment and functional outcomes in patients with anterior circulation large-vessel-occlusion stroke after reperfusion.
  • Utilized perfusion imaging to assess prolonged venous transit gradation.
  • Compared the impacts of superficial versus deep venous drainage dysfunction.
  • Analyzed functional outcomes in successfully reperfused stroke patients.
  • Deep venous drainage impairment strongly correlated with worse functional outcomes.
  • Prolonged venous transit was a significant prognostic biomarker.
  • Superficial venous drainage impairment had a lesser impact compared to deep venous impairment.

Abstract

PVT gradation based on Tmax ≥10 seconds timing in distinct venous territories provides prognostic insight into the differential contributions of superficial-versus-deep venous drainage dysfunction, supporting the use of PVT as a meaningful VO imaging biomarker. Deep VO impairment, as reflected by PVT2, is the primary driver of worse functional outcomes despite successful reperfusion in AIS-LVO, indicating its stronger negative prognostic impact compared with superficial VO impairment. These findings can help inform prognosis and postacute management strategies.

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Cite This Study

Mei et al. (2026) studied this question.

synapsesocial.com/papers/69abc1235af8044f7a4e9bbchttps://doi.org/10.3174/ajnr.a9074
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