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Table 2 Summary of the potential methods for early diagnosis of ICAS-LVO

From: Current knowledge of large vascular occlusion due to intracranial atherosclerosis: focusing on early diagnosis

Number Method Sign Sensitivity Specificity Accuracy Reference
1 DSA Residual stenosis after thrombectomy Presumed 100% Presumed 100% Presumed 100% Universally
2 DSA Better collateral circulation     [17,18,19]
3 DSA Truncal-type occlusion 53.1% 88.5% 84.2% [7, 20, 21]
4 DSA Microcatheter first-pass effect 90.9% 87.2% 88.5% [22]
5 DSA Tortuosity of occluded arteries     [23]
6 Histories and presentations Ipsilateral intermittent claudication or symptoms related to TIA     [1]
7 Histories and presentations Higher prevalence of hypertension, diabetes mellitus, dyslipidemia, smoking; the lower prevalence of atrial fibrillation     [5]
8 Histories and presentations Lower NIHSS     [5, 24]
9 Histories and presentations Carotid bruit     [31]
10 Histories and presentations Brachial pulse pressure     [32]
11 Plain CT scan High-density plaques 61.5% 68.3% 70.0% [33]
12 Plain CT scan Lower ASPECTS     [37, 38]
13 CTP Smaller core infarction area     [38]
14 CTA Poorer overall vascular condition     [42,43,44]
15 CTA Better collateral circulation (grades 2-4) 33.6% 89.3% 45.9% [45, 46]
16 CTA Without multi-segment clot sign 32.5% 94.6% 56.2% [47]
17 CTA Truncal-type occlusion 53.1% 88.5% 84.2% [21]
18 CTA Occlusion located at proximal M1 or proximal or middle BA     [48, 49]
19 CTA Shrinkage of artery proximal to the occlusion site     [50, 51]
20 DWI Lower infarct volume     [39]
21 DWI Core infarction located at deep part of the brain 93.3% 87.5% 88.5% [40]
22 MRA Similar to CTA     [41, 54, 55]
23 vwMRI Decreased blood lumen area     [63]
24 vwMRI Vessel wall enhancement     [64]
25 vwMRI Vessel wall “white snake sign,” narrowed of both inner and outer wall, concentric enhancement, thickening of wall     [65]
26 vwMRI Positive remodeling at the occlusion site     [67]
27 SWI Overestimation ratio of SVS ≤ 2.003 97.1% 91.3% 93.9% [68, 69]
28 Laboratory examination Higher homocysteine level     [70]
29 Laboratory examination Increased serum aldosterone level     [71]
30 Ultrasonography Vascular stenosis     [73]
31 IVUS Lumen stenosis     [74]
  1. DSA digital subtraction angiography, TIA transient ischemic attacks, NIHSS National Institutes Health Stroke Scale, CT computed tomography, ASPECTS Alberta Stroke Program Early CT Score, CTA CT angiography, BA basilar artery, SVS susceptibility vessel sign