CTA Collateral Status and Response to Recanalization in Patients with Acute Ischemic Stroke

Authors
V. NambiarS.I. SohnM.AAlmekhlafiH.W. ChangS. MishraE. QaziM. EesaA.M. DemchukM. GoyalM.D. HillB.K. Menon
Department
Dept. of Neurology (신경과학); Dept. of Radiology (영상의학); Brain Research Institute (뇌연구소)
Issue Date
2014
Citation
AJNR, American Journal of Neuroradiology, Vol.35(5) : 884-890, 2014
ISSN
0195-6108
Abstract
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
URI
http://kumel.medlib.dsmc.or.kr/handle/2015.oak/34874
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
File in this Item
oak-aaa-00109.pdf(693.05 kB)Download
Export
RIS (EndNote)
XLS (Excel)
XML


qrcode

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

BROWSE