Semi-automated measurement of vascular tortuosity and its implications for mechanical thrombectomy performance
Purpose Few studies have examined the geometry of endovascular mechanical thrombectomy pathways. Here we examine the tortuosity and angulations of catheter pathways from the aortic arch to the termination of the internal carotid artery (ICA) and its association with thrombectomy performance. Methods...
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| Veröffentlicht in: | Neuroradiology 2021-03, Vol.63 (3), p.381-389 |
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| creator | Mokin, Maxim Waqas, Muhammad Chin, Felix Rai, Hamid Senko, Jillian Sparks, Adam Ducharme, Richard W. Springer, Michael Borlongan, Cesario V. Levy, Elad I. Ionita, Ciprian Siddiqui, Adnan H. |
| description | Purpose
Few studies have examined the geometry of endovascular mechanical thrombectomy pathways. Here we examine the tortuosity and angulations of catheter pathways from the aortic arch to the termination of the internal carotid artery (ICA) and its association with thrombectomy performance.
Methods
We included 100 consecutive anterior circulation large vessel occlusion thrombectomy patients over 12 months. Computed tomography angiograms (CTA) were used for 3D segmentation of catheter pathway from the aortic arch to ICA termination. Tortuosity index (TI) and angulations of the catheter pathway were measured in a semi-automated fashion. TI and angulation degree were compared between sides and correlated with age and procedural measures.
Results
We analyzed 188 catheter pathways in 100 patients. Severe angulation (≤ 30°) was present in 5.8% and 39.4% of common carotid artery (CCA) and extracranial ICA segments, respectively. Five pathways (2.6%) had 360° loop. CCA and extracranial ICA tortuosity had a weak but significant correlation with age (
r
= 0.17, 0.21,
p
value = 0.05, 0.02 respectively), time from groin puncture to the site of occlusion (
r
= 0.29, 0.25,
p
values = 0.008, 0.026 respectively), and fluoroscopy time (
r
= 0.022, 0.31,
p
values = 0.016, 0.001 respectively). There was a significant difference in the pattern of angulation (
p
value = 0.04) and tortuosity between right and left side in CCA segment (TI = 0.20 ± 0.086 vs. 0.15 ± 0.82,
p
value < 0.001).
Conclusions
There was a significant difference in CCA angulation between right and left sides. TI of extracranial CCA and ICA correlated with age and influenced time from groin puncture to the occlusion site and total fluoroscopy time. |
| doi_str_mv | 10.1007/s00234-020-02525-6 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7880861</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2435757136</sourcerecordid><originalsourceid>FETCH-LOGICAL-c474t-5a576e9cce06be9f336f8749a92f8e8c90e00aafa0baef997fb14237df1adf6b3</originalsourceid><addsrcrecordid>eNp9kU9vFSEUxYnR2Gf1C7gwk7hxM3qBmWHYmJim2iZNXKhrcod36ZtmgCcwTd63l_pq_bNwASSc3z1wchh7yeEtB1DvMoCQXQsC6upF3w6P2IZ3UrRcC3jMNlUfW6k7OGHPcr4BAKmkespOpBj5ABo2LHwhP7e4luix0LbxhHlN5CmUJrrmFrNdF0xNiamsMc_l0GDYNnPJzez3y2yxzDHkxsVUZ-0OQ71amrJL0U9kq-2h2VOqssdg6Tl74nDJ9OL-PGXfPp5_Pbtorz5_ujz7cNXaTnWl7bFXA2lrCYaJtJNycKPqNGrhRhqtBgJAdAgTktNauYl3Qqqt47h1wyRP2fuj736dPG1tjZNwMfs0e0wHE3E2fyth3pnreGvUOMI48Grw5t4gxe8r5WL8nC0tCwaKazaik73qFZdDRV__g97ENYUar1LjqFTdRaXEkbIp5pzIPXyGg7mr0xzrNLVO87NOc2f96s8YDyO_-quAPAK5SuGa0u-3_2P7A0mFr2A</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2488772482</pqid></control><display><type>article</type><title>Semi-automated measurement of vascular tortuosity and its implications for mechanical thrombectomy performance</title><source>MEDLINE</source><source>SpringerLink Journals</source><creator>Mokin, Maxim ; Waqas, Muhammad ; Chin, Felix ; Rai, Hamid ; Senko, Jillian ; Sparks, Adam ; Ducharme, Richard W. ; Springer, Michael ; Borlongan, Cesario V. ; Levy, Elad I. ; Ionita, Ciprian ; Siddiqui, Adnan H.</creator><creatorcontrib>Mokin, Maxim ; Waqas, Muhammad ; Chin, Felix ; Rai, Hamid ; Senko, Jillian ; Sparks, Adam ; Ducharme, Richard W. ; Springer, Michael ; Borlongan, Cesario V. ; Levy, Elad I. ; Ionita, Ciprian ; Siddiqui, Adnan H.</creatorcontrib><description>Purpose
Few studies have examined the geometry of endovascular mechanical thrombectomy pathways. Here we examine the tortuosity and angulations of catheter pathways from the aortic arch to the termination of the internal carotid artery (ICA) and its association with thrombectomy performance.
Methods
We included 100 consecutive anterior circulation large vessel occlusion thrombectomy patients over 12 months. Computed tomography angiograms (CTA) were used for 3D segmentation of catheter pathway from the aortic arch to ICA termination. Tortuosity index (TI) and angulations of the catheter pathway were measured in a semi-automated fashion. TI and angulation degree were compared between sides and correlated with age and procedural measures.
Results
We analyzed 188 catheter pathways in 100 patients. Severe angulation (≤ 30°) was present in 5.8% and 39.4% of common carotid artery (CCA) and extracranial ICA segments, respectively. Five pathways (2.6%) had 360° loop. CCA and extracranial ICA tortuosity had a weak but significant correlation with age (
r
= 0.17, 0.21,
p
value = 0.05, 0.02 respectively), time from groin puncture to the site of occlusion (
r
= 0.29, 0.25,
p
values = 0.008, 0.026 respectively), and fluoroscopy time (
r
= 0.022, 0.31,
p
values = 0.016, 0.001 respectively). There was a significant difference in the pattern of angulation (
p
value = 0.04) and tortuosity between right and left side in CCA segment (TI = 0.20 ± 0.086 vs. 0.15 ± 0.82,
p
value < 0.001).
Conclusions
There was a significant difference in CCA angulation between right and left sides. TI of extracranial CCA and ICA correlated with age and influenced time from groin puncture to the occlusion site and total fluoroscopy time.</description><identifier>ISSN: 0028-3940</identifier><identifier>EISSN: 1432-1920</identifier><identifier>DOI: 10.1007/s00234-020-02525-6</identifier><identifier>PMID: 32816090</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Age ; Aorta ; Aorta, Thoracic ; Aortic arch ; Automation ; Blood vessels ; Cardiovascular system ; Carotid arteries ; Carotid artery ; Carotid Artery, Common ; Carotid Artery, Internal ; Catheters ; Computed tomography ; Correlation analysis ; Fluoroscopy ; Humans ; Imaging ; Interventional Neuroradiology ; Medical instruments ; Medicine ; Medicine & Public Health ; Neurology ; Neuroradiology ; Neurosciences ; Neurosurgery ; Occlusion ; Radiology ; Retrospective Studies ; Segmentation ; Segments ; Stroke ; Thrombectomy ; Tomography, X-Ray Computed ; Tortuosity ; Treatment Outcome</subject><ispartof>Neuroradiology, 2021-03, Vol.63 (3), p.381-389</ispartof><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2020</rights><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2020.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c474t-5a576e9cce06be9f336f8749a92f8e8c90e00aafa0baef997fb14237df1adf6b3</citedby><cites>FETCH-LOGICAL-c474t-5a576e9cce06be9f336f8749a92f8e8c90e00aafa0baef997fb14237df1adf6b3</cites><orcidid>0000-0002-9519-0059</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00234-020-02525-6$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00234-020-02525-6$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>230,314,776,780,881,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32816090$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mokin, Maxim</creatorcontrib><creatorcontrib>Waqas, Muhammad</creatorcontrib><creatorcontrib>Chin, Felix</creatorcontrib><creatorcontrib>Rai, Hamid</creatorcontrib><creatorcontrib>Senko, Jillian</creatorcontrib><creatorcontrib>Sparks, Adam</creatorcontrib><creatorcontrib>Ducharme, Richard W.</creatorcontrib><creatorcontrib>Springer, Michael</creatorcontrib><creatorcontrib>Borlongan, Cesario V.</creatorcontrib><creatorcontrib>Levy, Elad I.</creatorcontrib><creatorcontrib>Ionita, Ciprian</creatorcontrib><creatorcontrib>Siddiqui, Adnan H.</creatorcontrib><title>Semi-automated measurement of vascular tortuosity and its implications for mechanical thrombectomy performance</title><title>Neuroradiology</title><addtitle>Neuroradiology</addtitle><addtitle>Neuroradiology</addtitle><description>Purpose
Few studies have examined the geometry of endovascular mechanical thrombectomy pathways. Here we examine the tortuosity and angulations of catheter pathways from the aortic arch to the termination of the internal carotid artery (ICA) and its association with thrombectomy performance.
Methods
We included 100 consecutive anterior circulation large vessel occlusion thrombectomy patients over 12 months. Computed tomography angiograms (CTA) were used for 3D segmentation of catheter pathway from the aortic arch to ICA termination. Tortuosity index (TI) and angulations of the catheter pathway were measured in a semi-automated fashion. TI and angulation degree were compared between sides and correlated with age and procedural measures.
Results
We analyzed 188 catheter pathways in 100 patients. Severe angulation (≤ 30°) was present in 5.8% and 39.4% of common carotid artery (CCA) and extracranial ICA segments, respectively. Five pathways (2.6%) had 360° loop. CCA and extracranial ICA tortuosity had a weak but significant correlation with age (
r
= 0.17, 0.21,
p
value = 0.05, 0.02 respectively), time from groin puncture to the site of occlusion (
r
= 0.29, 0.25,
p
values = 0.008, 0.026 respectively), and fluoroscopy time (
r
= 0.022, 0.31,
p
values = 0.016, 0.001 respectively). There was a significant difference in the pattern of angulation (
p
value = 0.04) and tortuosity between right and left side in CCA segment (TI = 0.20 ± 0.086 vs. 0.15 ± 0.82,
p
value < 0.001).
Conclusions
There was a significant difference in CCA angulation between right and left sides. TI of extracranial CCA and ICA correlated with age and influenced time from groin puncture to the occlusion site and total fluoroscopy time.</description><subject>Age</subject><subject>Aorta</subject><subject>Aorta, Thoracic</subject><subject>Aortic arch</subject><subject>Automation</subject><subject>Blood vessels</subject><subject>Cardiovascular system</subject><subject>Carotid arteries</subject><subject>Carotid artery</subject><subject>Carotid Artery, Common</subject><subject>Carotid Artery, Internal</subject><subject>Catheters</subject><subject>Computed tomography</subject><subject>Correlation analysis</subject><subject>Fluoroscopy</subject><subject>Humans</subject><subject>Imaging</subject><subject>Interventional Neuroradiology</subject><subject>Medical instruments</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Neurology</subject><subject>Neuroradiology</subject><subject>Neurosciences</subject><subject>Neurosurgery</subject><subject>Occlusion</subject><subject>Radiology</subject><subject>Retrospective Studies</subject><subject>Segmentation</subject><subject>Segments</subject><subject>Stroke</subject><subject>Thrombectomy</subject><subject>Tomography, X-Ray Computed</subject><subject>Tortuosity</subject><subject>Treatment Outcome</subject><issn>0028-3940</issn><issn>1432-1920</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp9kU9vFSEUxYnR2Gf1C7gwk7hxM3qBmWHYmJim2iZNXKhrcod36ZtmgCcwTd63l_pq_bNwASSc3z1wchh7yeEtB1DvMoCQXQsC6upF3w6P2IZ3UrRcC3jMNlUfW6k7OGHPcr4BAKmkespOpBj5ABo2LHwhP7e4luix0LbxhHlN5CmUJrrmFrNdF0xNiamsMc_l0GDYNnPJzez3y2yxzDHkxsVUZ-0OQ71amrJL0U9kq-2h2VOqssdg6Tl74nDJ9OL-PGXfPp5_Pbtorz5_ujz7cNXaTnWl7bFXA2lrCYaJtJNycKPqNGrhRhqtBgJAdAgTktNauYl3Qqqt47h1wyRP2fuj736dPG1tjZNwMfs0e0wHE3E2fyth3pnreGvUOMI48Grw5t4gxe8r5WL8nC0tCwaKazaik73qFZdDRV__g97ENYUar1LjqFTdRaXEkbIp5pzIPXyGg7mr0xzrNLVO87NOc2f96s8YDyO_-quAPAK5SuGa0u-3_2P7A0mFr2A</recordid><startdate>20210301</startdate><enddate>20210301</enddate><creator>Mokin, Maxim</creator><creator>Waqas, Muhammad</creator><creator>Chin, 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B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7RV</scope><scope>7TK</scope><scope>7U7</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>M7P</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-9519-0059</orcidid></search><sort><creationdate>20210301</creationdate><title>Semi-automated measurement of vascular tortuosity and its implications for mechanical thrombectomy performance</title><author>Mokin, Maxim ; Waqas, Muhammad ; Chin, Felix ; Rai, Hamid ; Senko, Jillian ; Sparks, Adam ; Ducharme, Richard W. ; Springer, Michael ; Borlongan, Cesario V. ; Levy, Elad I. ; Ionita, Ciprian ; Siddiqui, Adnan H.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c474t-5a576e9cce06be9f336f8749a92f8e8c90e00aafa0baef997fb14237df1adf6b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Age</topic><topic>Aorta</topic><topic>Aorta, Thoracic</topic><topic>Aortic arch</topic><topic>Automation</topic><topic>Blood vessels</topic><topic>Cardiovascular system</topic><topic>Carotid arteries</topic><topic>Carotid artery</topic><topic>Carotid Artery, Common</topic><topic>Carotid Artery, Internal</topic><topic>Catheters</topic><topic>Computed tomography</topic><topic>Correlation analysis</topic><topic>Fluoroscopy</topic><topic>Humans</topic><topic>Imaging</topic><topic>Interventional Neuroradiology</topic><topic>Medical instruments</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Neurology</topic><topic>Neuroradiology</topic><topic>Neurosciences</topic><topic>Neurosurgery</topic><topic>Occlusion</topic><topic>Radiology</topic><topic>Retrospective Studies</topic><topic>Segmentation</topic><topic>Segments</topic><topic>Stroke</topic><topic>Thrombectomy</topic><topic>Tomography, X-Ray Computed</topic><topic>Tortuosity</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mokin, Maxim</creatorcontrib><creatorcontrib>Waqas, Muhammad</creatorcontrib><creatorcontrib>Chin, Felix</creatorcontrib><creatorcontrib>Rai, Hamid</creatorcontrib><creatorcontrib>Senko, Jillian</creatorcontrib><creatorcontrib>Sparks, Adam</creatorcontrib><creatorcontrib>Ducharme, Richard W.</creatorcontrib><creatorcontrib>Springer, Michael</creatorcontrib><creatorcontrib>Borlongan, Cesario V.</creatorcontrib><creatorcontrib>Levy, Elad I.</creatorcontrib><creatorcontrib>Ionita, Ciprian</creatorcontrib><creatorcontrib>Siddiqui, Adnan H.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Neurosciences Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma 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Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Neuroradiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mokin, Maxim</au><au>Waqas, Muhammad</au><au>Chin, Felix</au><au>Rai, Hamid</au><au>Senko, Jillian</au><au>Sparks, Adam</au><au>Ducharme, Richard W.</au><au>Springer, Michael</au><au>Borlongan, Cesario V.</au><au>Levy, Elad I.</au><au>Ionita, Ciprian</au><au>Siddiqui, Adnan H.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Semi-automated measurement of vascular tortuosity and its implications for mechanical thrombectomy performance</atitle><jtitle>Neuroradiology</jtitle><stitle>Neuroradiology</stitle><addtitle>Neuroradiology</addtitle><date>2021-03-01</date><risdate>2021</risdate><volume>63</volume><issue>3</issue><spage>381</spage><epage>389</epage><pages>381-389</pages><issn>0028-3940</issn><eissn>1432-1920</eissn><abstract>Purpose
Few studies have examined the geometry of endovascular mechanical thrombectomy pathways. Here we examine the tortuosity and angulations of catheter pathways from the aortic arch to the termination of the internal carotid artery (ICA) and its association with thrombectomy performance.
Methods
We included 100 consecutive anterior circulation large vessel occlusion thrombectomy patients over 12 months. Computed tomography angiograms (CTA) were used for 3D segmentation of catheter pathway from the aortic arch to ICA termination. Tortuosity index (TI) and angulations of the catheter pathway were measured in a semi-automated fashion. TI and angulation degree were compared between sides and correlated with age and procedural measures.
Results
We analyzed 188 catheter pathways in 100 patients. Severe angulation (≤ 30°) was present in 5.8% and 39.4% of common carotid artery (CCA) and extracranial ICA segments, respectively. Five pathways (2.6%) had 360° loop. CCA and extracranial ICA tortuosity had a weak but significant correlation with age (
r
= 0.17, 0.21,
p
value = 0.05, 0.02 respectively), time from groin puncture to the site of occlusion (
r
= 0.29, 0.25,
p
values = 0.008, 0.026 respectively), and fluoroscopy time (
r
= 0.022, 0.31,
p
values = 0.016, 0.001 respectively). There was a significant difference in the pattern of angulation (
p
value = 0.04) and tortuosity between right and left side in CCA segment (TI = 0.20 ± 0.086 vs. 0.15 ± 0.82,
p
value < 0.001).
Conclusions
There was a significant difference in CCA angulation between right and left sides. TI of extracranial CCA and ICA correlated with age and influenced time from groin puncture to the occlusion site and total fluoroscopy time.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>32816090</pmid><doi>10.1007/s00234-020-02525-6</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-9519-0059</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0028-3940 |
| ispartof | Neuroradiology, 2021-03, Vol.63 (3), p.381-389 |
| issn | 0028-3940 1432-1920 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7880861 |
| source | MEDLINE; SpringerLink Journals |
| subjects | Age Aorta Aorta, Thoracic Aortic arch Automation Blood vessels Cardiovascular system Carotid arteries Carotid artery Carotid Artery, Common Carotid Artery, Internal Catheters Computed tomography Correlation analysis Fluoroscopy Humans Imaging Interventional Neuroradiology Medical instruments Medicine Medicine & Public Health Neurology Neuroradiology Neurosciences Neurosurgery Occlusion Radiology Retrospective Studies Segmentation Segments Stroke Thrombectomy Tomography, X-Ray Computed Tortuosity Treatment Outcome |
| title | Semi-automated measurement of vascular tortuosity and its implications for mechanical thrombectomy performance |
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