Prognostic significance of the prominent vein sign on susceptibility-weighted imaging for collateral circulation assessment in acute large vessel occlusion stroke: a systematic review and meta-analysis

Krishnan, Ponnarasan and Tharek, Anas and Al-Akmal Noralam, Noor Hayatul and Shamsuddin Perisamy, Rajeev and Muda, Ahmad Sobri (2025) Prognostic significance of the prominent vein sign on susceptibility-weighted imaging for collateral circulation assessment in acute large vessel occlusion stroke: a systematic review and meta-analysis. Tianjin Daxue Xuebao (Ziran Kexue yu Gongcheng Jishu Ban)/ Journal of Tianjin University Science and Technology, 58 (8:2025). pp. 573-632. E-ISSN 0493-2137

PDF - Published Version Restricted to Registered users only Download (863kB) | Request a copy

Abstract

Acute ischemic stroke (AIS) due to large vessel occlusion (LVO) presents significant challenges in clinical management, with collateral circulation playing a pivotal role in determining tissue viability and patient outcomes. Susceptibility-weighted imaging (SWI) has emerged as a valuable non-invasive modality for assessing cerebral hemodynamics by visualizing the prominent vein sign (PVS), which reflects increased deoxyhemoglobin concentration and oxygen extraction in hypoperfused brain regions. This synthesis examines the pathophysiological basis, prevalence, and imaging characteristics of PVS, highlighting its correlation with leptomeningeal collateralization and its prognostic significance in both short- and long-term functional outcomes. Comparative analyses with other imaging techniques, including diffusion-weighted imaging (DWI), perfusion-weighted imaging (PWI), magnetic resonance angiography (MRA), and computed tomography angiography (CTA), underscore the complementary role of SWI in collateral assessment. The integration of quantitative and qualitative PVS evaluation methods enhances the accuracy of collateral grading and supports individualized treatment planning, particularly in selecting candidates for recanalization therapies. Challenges related to technical variability, interpretative subjectivity, and confounding clinical factors are addressed, emphasizing the need for standardized imaging protocols and robust validation. Emerging technological innovations and advanced analytic approaches promise to refine collateral imaging further, facilitating personalized stroke therapy. Incorporating PVS assessment into routine clinical workflows offers a non-contrast, accessible tool to improve prognostication and optimize therapeutic strategies in acute LVO stroke management.

Item Type:	Article (Journal)
Uncontrolled Keywords:	Prognostic Significance, Prominent Vein Sign (PVS), Susceptibility-Weighted Imaging (SWI), Collateral Circulation, Acute Ischemic Stroke, Large Vessel Occlusion (LVO), Stroke Imaging Biomarkers, Cerebral Perfusion, Stroke Prognosis, Meta-Analysis, Systematic Review.
Subjects:	R Medicine > R Medicine (General) R Medicine > RC Internal medicine
Kulliyyahs/Centres/Divisions/Institutes (Can select more than one option. Press CONTROL button):	UNSPECIFIED
Depositing User:	Dr Rajeev Shamsuddin Perisamy
Date Deposited:	12 Sep 2025 10:37
Last Modified:	12 Sep 2025 10:37
URI:	http://irep.iium.edu.my/id/eprint/123167

Actions (login required)

View Item