Preliminary Application of a Quantitative Collateral Assessment Method in Acute Ischemic Stroke Patients With Endovascular Treatments: A Single-Center Study

Cao, Ruoyao; Qi, Peng; Jiang, Yun; Shen, Huiyong; Ye, Gengfan; Zhu, Yaxin; Li, Ling; You, Zilong; Chen, Juan

doi:10.3389/fneur.2021.714313

Cited by 6 publications

(8 citation statements)

References 33 publications

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“…There has been a connection between large infarct length and poor collateral circulation, according to previous studies, perhaps because the presence of a larger penumbra is associated with excellent movement within the collateral pathway, and the time window for possible reperfusion can be extended by prolonging the survival time of the penumbra [25]. According to a study published in 2021, ischemic stroke victims who present within 24 hours of onset have extremely high chances of surviving; the penumbra device permits for secure and effective revascularisation; in other phrases, properly collateral stream limits the enlargement of the infarct core and determines the final infarct volume [16]. Thus, CES related to atrial traumatic inflammation is related to more extreme hypoperfusion, main to larger infarct volumes, extra intense haemorrhagic transformation, and worse stroke outcomes than LAA [26,27].…”

Section: Discussionmentioning

confidence: 99%

“…The electricity of the collateral circulation is extra essential for tissue fate than the collateral filling price [14,15]. The collateral stream is quite variable between individuals, and the optimum time of series is also in my view variable [16]. The CTP generates a couple of maps of ischemic tissue and is a regarded decision-making device for patients with acute ischemic stroke [17].…”

Section: Introductionmentioning

confidence: 99%

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NT-proBNP Levels and Collateral Circulation Status in Patients with Acute Ischemic Stroke

et al. 2023

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Background and Objectives. Strokes resulting from atrial fibrillation (AF) increase with age. The relationship between N-terminal- (NT-) prohormone brain natriuretic peptide (NT-proBNP) level and National Institutes of Health Stroke Scale (NIHSS) score is not well established. Also, the collateral circulation plays an important role in NHISS scores. In this study, the effects of NT-proBNP on collateralization were assessed in patients with and without AF. Methods. In this study, 326 hospitalized patients with acute anterior circulation ischemic stroke (AACIS) were included. A comparison of the clinical characteristics of those with and without AF was conducted. The Spearman rank correlation was used for the correlation analysis of plasma NT-proBNP level, regional leptomeningeal collateral (rLMC) score, and computed tomography perfusion (CTP) status in the AF and non-AF groups. An analysis of multivariate linear regression was used to determine how plasma NT-proBNP level, rLMC score, and CTP status influenced the score on the NIHSS. Results. There was a greater plasma NT-proBNP level in the AF group compared with the non-AF group, an increased CTP volume (including CTP ischemic volume, CTP infarct core volume, and CTP ischemic penumbra volume ( P = 0.002 )), higher NIHSS score on admission, and lower rLMC score ( P < 0.001 for the remaining parameters). A negative correlation exists between plasma NT-proBNP level and rLMC score ( r = − 0.156 , P = 0.022 ), but a positive correlation exists between plasma NT-proBNP level and both CTP ischemic volume and CTP infarct core volume ( r = 0.148 , P = 0.003 ) in the AF group, but not in the non-AF group. Multivariate linear regression analysis demonstrated that NT-proBNP, CTP ischemic penumbra volume, and rLMC score were associated with NIHSS score, and NT-proBNP was positively associated with NIHSS scores (95% confidence interval (CI), 0.000-0.002; P = 0.004 ) in the AF group, whatever in the unadjusted model or adjusted models, but not in the nonlarge artery atherosclerosis (LAA) group. Conclusion. In AACIS patients with AF, NT-proBNP level negatively correlated with collateral status, positively with CTP ischemic volume, and positively with NIHSS score.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

NT-proBNP Levels and Collateral Circulation Status in Patients with Acute Ischemic Stroke

et al. 2023

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“…Assessment of CS can be time-consuming, subjective, and the challenge for the manual scoring system is the low agreement between evaluators, making patient characterization less consistent. Several studies have shown that fully automated or semi-automated methods are a quantitative, reliable, time-saving, and user-independent measure of CS on baseline CTA ( 12 , 14 , 22 ). Semiautomated CS evaluation has been associated with clinical outcome previously in AIS patients treated with EVT ( 22 ), however, to the best of our knowledge the relationship between admission BP and automatically measured CS had not been previously described.…”

Section: Discussionmentioning

confidence: 99%

Automated scoring of collaterals, blood pressure, and clinical outcome after endovascular treatment in patients with acute ischemic stroke and large-vessel occlusion

Guisado‐Alonso

Camps‐Renom²,

Delgado-Mederos³

et al. 2022

Front. Neurol.

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IntroductionWe aimed to determine whether the degree of collateral circulation is associated with blood pressure at admission in acute ischemic stroke patients treated with endovascular treatment and to determine its prognostic value.MethodsWe evaluated patients with anterior large vessel occlusion treated with endovascular treatment in a single-center prospective registry. We collected clinical and radiological data. Automated and validated software (Brainomix Ltd., Oxford, UK) was used to generate the collateral score (CS) from the baseline single-phase CT angiography: 0, filling of ≤10% of the occluded MCA territory; 1, 11–50%; 2, 51–90%; 3, >90%. When dichotomized, we considered that CS was good (CS = 2–3), or poor (CS = 0–1). We performed bivariate and multivariable ordinal logistic regression analysis to predict CS categories in our population. The secondary outcome was to determine the influence of automated CS on functional outcome at 3 months. We defined favorable functional outcomes as mRS 0–2 at 3 months.ResultsWe included 101 patients with a mean age of 72.1 ± 13.1 years and 57 (56.4%) of them were women. We classified patients into 4 groups according to the CS: 7 patients (6.9%) as CS = 0, 15 (14.9%) as CS = 1, 43 (42.6%) as CS = 2 and 36 (35.6%) as CS = 3. Admission systolic blood pressure [aOR per 10 mmHg increase 0.79 (95% CI 0.68–0.92)] and higher baseline NIHSS [aOR 0.90 (95% CI, 0.84–0.96)] were associated with a worse CS. The OR of improving 1 point on the 3-month mRS was 1.63 (95% CI, 1.10–2.44) favoring a better CS (p = 0.016).ConclusionIn acute ischemic stroke patients with anterior large vessel occlusion treated with endovascular treatment, admission systolic blood pressure was inversely associated with the automated scoring of CS on baseline CT angiography. Moreover, a good CS was associated with a favorable outcome.

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“…These interesting results revealed that the disagreement mainly occurred within the sets of Tan score 0 and 1 (0–50%) or Tan score 2 and 3 (50–100%). Recently, another quantitative measurement of the collateral circulation (V CCq ) was proposed—the method calculating vessel volumes using the identified CT values at three selected layers on time maximum intensity projection (tMIP) CTA images ( Cao et al, 2021 ). The study showed that both V CCq and Tan score were moderately negatively correlated with final infarct volume; however, unlike Tan score, V CCq was an independent predictive factor of the clinical outcome (OR = 0.14, P = 0.009).…”

Section: Discussionmentioning

confidence: 99%

Quantitative collateral score for the prediction of clinical outcomes in stroke patients: Better than visual grading

Zhang²,

Cao³

et al. 2022

Front. Neurosci.

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ObjectivesTo identify preoperative prognostic factors for acute ischemic stroke (AIS) patients receiving mechanical thrombectomy (MT) and compare the performance of quantitative collateral score (qCS) and visual collateral score (vCS) in outcome prediction.MethodsFifty-five patients with AIS receiving MT were retrospectively enrolled. qCS was defined as the percentage of the volume of collaterals of both hemispheres. Based on the dichotomous outcome assessed using a 90-day modified Rankin Scale (mRS), we compared qCS, vCS, age, sex, National Institute of Health stroke scale score, etiological subtype, platelet count, international normalized ratio, glucose levels, and low-density lipoprotein cholesterol (LDL-C) levels between favorable and unfavorable outcome groups. Logistic regression analysis was performed to determine the effect on the clinical outcome. The discriminatory power of qCS, vCS, and their combination with cofounders for determining favorable outcomes was tested with the area under the receiver-operating characteristic curve (AUC).ResultsvCS, qCS, LDL-C, and age could all predict clinical outcomes. qCS is superior over vCS in predicting favorable outcomes with a relatively higher AUC value (qCS vs. vCS: 0.81 vs. 0.74) and a higher sensitivity rate (qCS vs. vCS: 72.7% vs. 40.9%). The prediction power of qCS + LDL-C + age was best with an AUC value of 0.91, but the accuracy was just increased slightly compared to that of qCS alone.ConclusionCollateral scores, LDL-C and age were independent prognostic predictors for patients with AIS receiving MT; qCS was a better predictor than vCS. Furthermore, qCS + LDL-C + age offers a strong prognostic prediction power and qCS alone was another good choice for predicting clinical outcome.

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Preliminary Application of a Quantitative Collateral Assessment Method in Acute Ischemic Stroke Patients With Endovascular Treatments: A Single-Center Study

Cited by 6 publications

References 33 publications

NT-proBNP Levels and Collateral Circulation Status in Patients with Acute Ischemic Stroke

NT-proBNP Levels and Collateral Circulation Status in Patients with Acute Ischemic Stroke

Automated scoring of collaterals, blood pressure, and clinical outcome after endovascular treatment in patients with acute ischemic stroke and large-vessel occlusion

Quantitative collateral score for the prediction of clinical outcomes in stroke patients: Better than visual grading

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