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

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Author(s)
Rajsrinivas ParthasarathySung-II SohnThomas JeerakathilMahesh P. KateSachin M. MishraVivek K. NambiarAftab AhmadBijoy K. MenonAshfaq Shuaib
Keimyung Author(s)
Sohn, Sung Il
Department
Dept. of Neurology (신경과학)
Brain Research Institute (뇌연구소)
Journal Title
Journal of Neuroimaging
Issued Date
2015
Volume
25
Issue
6
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.
Keimyung Author(s)(Kor)
손성일
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
Source
https://onlinelibrary.wiley.com/doi/abs/10.1111/jon.12260
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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