Anterior ischemic stroke: Comparison of two clinical outcome prediction scores through the investigation of cerebral collaterals using multiphase CT angiography

Nigron, Audrey; Bourgois, Nathalie; Dao, Salif; Lambert, C; Perrier, Marie-Josée; Akono, S.; Moreno, Ricardo; Chabert, Emmanuel; Bourbeau, Jean; Claise, Béatrice; Gerbaud, Laurent; Boyer, L.; Zerroug, Abderahim

doi:10.1016/j.neurad.2019.03.016

Cited by 3 publications

(4 citation statements)

References 18 publications

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“…Several factors can affect the generation of the final perfusion maps, such as the differences of software operators and software applications. Menon score has been widely used in collateral circulation scoring with good repeatability and simple procedure 11 . The pial collateral circulation score on mCTA can be evaluated with more standardized imaging protocols.…”

Section: Discussionmentioning

confidence: 99%

“…Menon score has been widely used in collateral circulation scoring with good repeatability and simple procedure. 11 The pial collateral circulation score on mCTA can be evaluated with more standardized imaging protocols. However, there is a concern that continuous, repeat scans of CTP and mCTA can increase the effective radiation dose.…”

Section: Discussionmentioning

confidence: 99%

“…The mRS score at 90 days was then obtained by telephone interviews with the patients or their guardians by 2 trained neurologists. The favorable midterm functional outcome was defined as a 90-day mRS score of 0, 1, or 2, whereas the unfavorable outcome was defined as a 90-day mRS score of >2 (90-day mRS score of 3 designate a moderate disability; 4 and 5, a severe disability; and 6, death) 11 . Intracerebral hemorrhage was defined as a new hyperattenuated region identified on the follow-up CT scan after thrombectomy.…”

Section: Methodsmentioning

confidence: 99%

“…The favorable midterm functional outcome was defined as a 90-day mRS score of 0, 1, or 2, whereas the unfavorable outcome was defined as a 90-day mRS score of >2 (90-day mRS score of 3 designate a moderate disability; 4 and 5, a severe disability; and 6, death). 11 Intracerebral hemorrhage was defined as a new hyperattenuated region identified on the follow-up CT scan after thrombectomy. If the new hyperattenuated region completely cleared within 48 hours, it was considered to have contrast extravasation and was not considered to have intracerebral hemorrhage.…”

Section: Image Analysis and Clinical Assessmentmentioning

confidence: 99%

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Risk and Benefit Evaluation: Application of Multiphase Computed Tomography Angiography in Mechanical Thrombectomy for Patients With Acute Ischemic Stroke

Yu¹,

Pan²,

Zhao³

et al. 2021

J Comput Assist Tomogr

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Objective:The objective of this study was to evaluate the collateral circulation in patients with acute ischemic stroke (AIS) by multiphase computed tomography angiography (mCTA) and explore its application value in the risk and benefit assessment after thrombectomy.Methods: Clinical and imaging parameters of AIS patients who underwent thrombectomy were consecutively collected. The 90-day modified Rankin Scale (mRS) score was used as the standard for evaluating the recovery of neurological functions. The receiver operating characteristic curve and correlation analysis were used to evaluate the diagnostic efficacy of collateral circulation in the clinical outcomes at 90 days and the correlation with symptomatic intracerebral hemorrhage (sICH), respectively.Results: Thirty of 58 AIS patients (51.7%) had favorable functional recovery (90-day mRS score, ≤2). Significant differences were observed in age, time from symptom onset to groin puncture, National Institutes of Health Stroke Scale score at admission and 24 hours after thrombectomy, mRS score at discharge, collateral circulation score, and target mismatch between the favorable and unfavorable groups (P < 0.05). The diagnostic efficacy of mCTA collateral score (area under the curve, 0.697; 95% confidence interval, 0.563-0.831) was similar to that of computed tomography perfusion target mismatch (area under the curve, 0.740; 95% confidence interval, 0.609-0.872) (DeLong test, P = 0.575). The collateral circulation score was significantly negatively correlated with sICH (ρ = −0.607, P < 0.001). Patients with sICH had lower collateral circulation scores and higher 90-day mRS scores (P < 0.05). Conclusions:The mCTA collateral score has good application value in the risk and benefit evaluation after mechanical thrombectomy, and it is well suited for routine emergency assessment of AIS patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Image Analysis and Clinical Assessmentmentioning

confidence: 99%

See 2 more Smart Citations

Risk and Benefit Evaluation: Application of Multiphase Computed Tomography Angiography in Mechanical Thrombectomy for Patients With Acute Ischemic Stroke

Yu¹,

Pan²,

Zhao³

et al. 2021

J Comput Assist Tomogr

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Time-resolved assessment of cortical venous drainage on multiphase CT angiography in patients with acute ischemic stroke

et al. 2021

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The effect of occlusion location and technique in mechanical thrombectomy for minor stroke

Abecassis,

Almallouhi,

Chalhoub

et al. 2023

Interv Neuroradiol

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Introduction Endovascular mechanical thrombectomy (MT) is an established treatment for large vessel occlusion strokes with a National Institutes of Health Stroke Scale (NIHSS) score of 6 or higher. Data pertaining to minor strokes, medium, or distal vessel occlusions, and most effective MT technique is limited and controversial. Methods A multicenter retrospective study of all patients treated with MT presenting with NIHSS score of 5 or less at 29 comprehensive stroke centers. The cohort was dichotomized based on location of occlusion (proximal vs. distal) and divided based on MT technique (direct aspiration first-pass technique [ADAPT], stent retriever [SR], and primary combined [PC]). Outcomes at discharge and 90 days were compared between proximal and distal occlusion groups, and across MT techniques. Results The cohort included 759 patients, 34% presented with distal occlusion. Distal occlusions were more likely to present with atrial fibrillation (p = 0.008) and receive IV tPA (p = 0.001). Clinical outcomes at discharge and 90 days were comparable between proximal and distal groups. Compared to SR, patients managed with ADAPT were more likely to have a modified Rankin Scale of 0–2 at discharge and at 90 days (p = 0.024 and p = 0.013). Primary combined compared to ADAPT, prior stroke, multiple passes, older age, and longer procedure time were independently associated with worse clinical outcome, while successful recanalization was positively associated with good clinical outcomes. Conclusions Proximal and distal occlusions with low NIHSS have comparable outcomes and safety profiles. While all MT techniques have a similar safety profile, ADAPT was associated with better clinical outcomes at discharge and 90 days.

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Anterior ischemic stroke: Comparison of two clinical outcome prediction scores through the investigation of cerebral collaterals using multiphase CT angiography

Cited by 3 publications

References 18 publications

Risk and Benefit Evaluation: Application of Multiphase Computed Tomography Angiography in Mechanical Thrombectomy for Patients With Acute Ischemic Stroke

Risk and Benefit Evaluation: Application of Multiphase Computed Tomography Angiography in Mechanical Thrombectomy for Patients With Acute Ischemic Stroke

Time-resolved assessment of cortical venous drainage on multiphase CT angiography in patients with acute ischemic stroke

The effect of occlusion location and technique in mechanical thrombectomy for minor stroke

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