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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