https://cesia-api.mycvns.com/index.php/journal <p><strong>Cardiovascular, Neurovascular &amp; Stroke (</strong>CVNS) Journal is an open-access, multidisciplinary, peer-reviewed medical journal for cardiovascular, neurovascular, as well as stroke medicine. We accept and publish articles that revolves around these specialties including the new trends in image-guided therapy (IGT). </p> <p><strong>Digital Archive</strong><br />The articles published in the CVNS will be assigned with digital object identifier (DOI). </p> <hr style="border-width: 1px 1px 0; border-style: solid; border-color: #dddedc; width: 100%; margin-left: auto; margin-right: auto;" /> en-US [email protected] (Mohamad Syafeeq Faeez Md Noh) [email protected] (Mohamad Zulfadhli) Tue, 30 Jun 2026 14:12:33 +0000 OJS 3.3.0.14 http://blogs.law.harvard.edu/tech/rss 60 https://cesia-api.mycvns.com/index.php/journal/article/view/205 <p><strong>Background: </strong>MRI-first pathways prioritize tissue-based selection in acute ischemic stroke (AIS). This study evaluated workflow metrics and functional outcomes in revascularized AIS patients managed through an MRI-first protocol. <strong>Methods: </strong>We conducted a retrospective cohort study of 59 consecutive revascularized AIS patients managed with the Putra Acute Stroke Protocol at a comprehensive stroke center. Primary workflow metrics were door-to-imaging (DTI) and door-to-decision (DTD) times. The primary outcome was 90-day functional independence, defined as modified Rankin Scale (mRS) 0-2. Multivariable logistic regression was used to identify factors associated with a favourable outcome. <strong>Results: </strong>The MRI-first pathway identified 20.1% stroke mimics and 14.1% transient ischemic attacks before revascularization decisions. Among revascularized patients, median DTI was 45 minutes (IQR 35-69) and median DTD was 67 minutes (IQR 50-98), with a median imaging-to-decision interval of 22 minutes. In multivariable analysis, baseline NIHSS (aOR 0.887; 95% CI 0.800-0.984, p=0.023) and DTD time (aOR 1.022; 95% CI 1.000-1.044, p=0.048) were associated with a favourable 90-day outcome. <strong>Conclusion: </strong>In this selected cohort of revascularized patients managed through an MRI-first pathway, workflow performance was acceptable for a comprehensive stroke center, and favourable 90-day functional outcomes were achieved in two-thirds of patients. The observed positive association between longer door-to-decision time and favourable outcome should be interpreted cautiously, as it may reflect selection bias and residual confounding inherent to the retrospective design. Larger prospective multicenter studies are needed to confirm these findings.</p> <p><strong>Key words:</strong> acute ischemic stroke; magnetic resonance imaging; workflow metrics; door-to-imaging; door-to-decision; thrombolysis; thrombectomy</p> Izzna Shafinaz Abu Bakar, Ahmad Sobri Muda, Norhafizah Ehsan, Rajeev Shamsuddin Perisamy, Mohd Fandi Al-Khafiz Kamis, Anas Tharek, Muhammad Izzat Ahmad Sabri, Nurain Mahfar Copyright (c) 2026 https://creativecommons.org/licenses/by-sa/4.0 https://cesia-api.mycvns.com/index.php/journal/article/view/205 Tue, 30 Jun 2026 00:00:00 +0000