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A Combined Arterial and Venous Grading Scale to Predict Outcome in Anterior Circulation Ischemic Stroke

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Affiliated Author(s)
손성일
Alternative Author(s)
Sohn, Sung Il
Journal Title
Journal of Neuroimaging
ISSN
1051-2284
Issued Date
2015
Keyword
Cerebral veinsCerebral perfusionAcute ischemic strokeCollateralsPrognosisCT angiographyImaging
Abstract
OBJECTIVE: Prognostic evaluation based on cortical vein score difference in stroke (PRECISE) score, a novel venous grading
scale better predicted stroke outcomes. Henceforth, we aimed to describe and determine if a physiologically relevant combined
arterial and venous grading scale (CRISP grading scale) is accurate in determining 90-day stroke outcomes in patients with
proximal arterial occlusion in the anterior circulation.
METHODS: Data are from the Keimyung Stroke Registry. Consecutive patients with M1 middle cerebral artery (MCA) or
terminal internal carotid artery (ICA) occlusion on CT-angiography (CTA) from May-2004 to July-2008 were included. The affected
hemisphere ‘four veins composite score’ and ‘arterial collaterals’ were each graded ‘good’ and ‘poor’. On the combined scale, a
‘good’ grade represented a ‘good’ score on both scales and a ‘poor’ grade represented a ‘poor’ score on both scales. The ‘other two’
combinations were graded ‘intermediate.’
RESULTS: Eighty-one patients were included in the study. Dummy variable regression analysis demonstrated that poor
outcome was commonly seen in the group with poor arterial and venous grades [OR(95%CI); 48 (8.24, 279.598); P < 0.00001]
as opposed to poor arterial collaterals alone [OR(95%CI); 9.6(1.483,62.162); P = 0.018]. In multivariate analysis the CRISP grade
[OR(95%CI); 2.638(1.192, 6.039), P = 0.017] and National Institutes of Health Stroke Scale [OR(95%CI);1.230(1.085, 1.395),
P = 0.001(per unit increase)] emerged as the independent predictors of poor outcome (modified Rankin Scale >2) when adjusted
for other imaging predictors of outcome.
CONCLUSION: CRISP grading was precise in predicting stroke outcomes when compared to individual imaging scales including
arterial collateral grading, PRECISE score and CTA-SI ASPECTS in patients with proximal arterial occlusion in the anterior circulation.
Department
Dept. of Neurology (신경과학)
Brain Research Institute (뇌연구소)
Publisher
School of Medicine
Citation
Rajsrinivas Parthasarathy et al. (2015). A Combined Arterial and Venous Grading Scale to Predict Outcome in Anterior Circulation Ischemic Stroke. Journal of Neuroimaging, 25(6), 969–977. doi: 10.1111/jon.12260
Type
Article
ISSN
1051-2284
DOI
10.1111/jon.12260
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/32887
Appears in Collections:
3. Research Institutues (연구소) > Brain Research Institute (뇌연구소)
1. School of Medicine (의과대학) > Dept. of Neurology (신경과학)
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