ISC 2026 | An external validation study comparing six established prediction scales for ICAD-related LVO
Kenichi Sakuta, MD, PhD, Jikei University School of Medicine, Minato, Japan,
discusses the findings of an external validation study comparing six established prediction scales for intracranial atherosclerotic disease (ICAD)-related large vessel occlusion (LVO). Dr Sakuta notes that imaging factors provide direct information on atherosclerotic burden, making them more important than clinical factors like atrial fibrillation absence. This interview took place at the 2026 International Stroke Congress (ISC), held in New Orleans, LA.
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Transcript
We performed an external validation study using a two-center prospectively maintained stroke registry at Jikei University. We compared six established prediction scales to see which one accurately predicts ICAD-related LVO. The results show that only the REMIT scale and the score ICAD show robust performance. But the most important insight came from our component analysis. We calculated the odds ratio for every single component of all six scales...
We performed an external validation study using a two-center prospectively maintained stroke registry at Jikei University. We compared six established prediction scales to see which one accurately predicts ICAD-related LVO. The results show that only the REMIT scale and the score ICAD show robust performance. But the most important insight came from our component analysis. We calculated the odds ratio for every single component of all six scales. And as a result, imaging factors outperform clinical factors. While clinical factors like atrial fibrillation absence are important, it’s only indirect information. So imaging factors show atherosclerotic burden directly. That’s why imaging factors are more important than clinical factors. With these insights, I’d like to refine these prediction strategies using various imaging factors.
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