CTA Collateral Status and Response to Recanalization in Patients with Acute Ischemic Stroke
- V. Nambiar; S.I. Sohn; M.A; Almekhlafi; H.W. Chang; S. Mishra; E. Qazi; M. Eesa; A.M. Demchuk; M. Goyal; M.D. Hill; B.K. Menon
- Dept. of Neurology (신경과학); Dept. of Radiology (영상의학); Brain Research Institute (뇌연구소)
- Issue Date
- AJNR, American Journal of Neuroradiology, Vol.35(5) : 884-890, 2014
- BACKGROUND AND PURPOSE: Collateral status at baseline is an independent determinant of clinical outcome among patients with
acute ischemic stroke. We sought to identify whether the association between recanalization after intra-arterial acute stroke therapy and
favorable clinical response is modified by the presence of good collateral flow assessed on baseline CTA.
MATERIALS AND METHODS: Data are from the Keimyung Stroke Registry, a prospective cohort study of patients with acute ischemic
stroke from Daegu, South Korea. Patients with M1 segment MCA with or without intracranial ICA occlusions on baseline CTA from May
2004 to July 2009 who also had baseline MR imaging were included. Two readers blinded to all clinical information assessed baseline and
follow-up imaging. Leptomeningeal collaterals on baseline CTA were assessed by consensus by use of the regional leptomeningeal score.
RESULTS: Among 84 patients (mean age, 65.2 13.2 years; median NIHSS score, 14; interquartile range, 8.5), median time from stroke onset
to initial MR imaging was 164 minutes. TICI 2b–3 recanalization was achieved in 38.1% of patients and mRS 0–2 at 90 days in 35.8% of
patients. In a multivariable model, the interaction between collateral status and recanalization was significant. Only patients with intermediate
or good collaterals who recanalized showed a statistically significant association with good clinical outcome (rate ratio 3.8; 95%
CI, 1.2–12.1). Patients with good and intermediate collaterals who did not achieve recanalization and patients with poor collaterals, even if
they achieved recanalization, did not do well.
CONCLUSIONS: Patients with good or intermediate collaterals on CTA benefit from intra-arterial therapy, whereas patients with poor
collaterals do not benefit from treatment.
ABBREVIATIONS: IAT intra-arterial therapy; rLMC regional leptomeningeal collateral score; SD standard deviation
- Appears in Collections:
- 1. Journal Papers (연구논문) > 1. School of Medicine (의과대학) > Dept. of Neurology (신경과학)
1. Journal Papers (연구논문) > 1. School of Medicine (의과대학) > Dept. of Radiology (영상의학)
1. Journal Papers (연구논문) > 3. Research Institutues (연구소) > Brain Research Institute (뇌연구소)
- Keimyung Author(s)
- 손성일; 장혁원
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