Scoring of Middle Cerebral Artery Collaterals Predicts RAPID CT-Perfusion Analysis and Short-Term Outcomes in Acute Ischemic Stroke Patients Undergoing Thrombectomy

Shah, Varun; Eaton, Ryan G.; Cua, Santino; Dornbos, David; Hoang, Nguyen; Schunemann, Victoria; Nimjee, Shahid M; Youssef, Patrick; Powers, Ciarán J.

doi:10.1016/j.wneu.2019.12.033

Cited by 5 publications

(3 citation statements)

References 21 publications

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“…Several clinical studies have revealed that 25%–42% of patients who achieve successful large-vessel recanalization following mechanical thrombectomy still exhibit the NRP, as detected through cerebral perfusion imaging. [ 9 ] This phenomenon is closely associated with a larger final cerebral infarction volume and poor clinical prognosis. In 2012, Dalkara and Arsava noted that existing clinical studies showed an incidence rate of at least 25% for the NRP in patients with successful cerebral vascular recanalization.…”

Section: The No-reflow Phenomenonmentioning

confidence: 99%

No-reflow phenomenon following stroke recanalization therapy: Clinical assessment advances: A narrative review

Kan,

Li,

Zhang

et al. 2023

Brain Circulation

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The no-reflow phenomenon (NRP) after successful vascular recanalization in acute ischemic stroke (AIS) has become a major cause of poor clinical prognosis and ineffective recanalization. However, there is currently no clear definition or unified clinical assessment method for the NRP. Therefore, it is urgent to clarify the clinical evaluation criteria for the NRP and develop new no-reflow evaluation techniques so that remedial treatment can be applied to AIS patients suffering from the NRP. In this brief review, a variety of NRP assessment methods and defining criteria for clinical practice are presented.

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Section: The No-reflow Phenomenonmentioning

confidence: 99%

No-reflow phenomenon following stroke recanalization therapy: Clinical assessment advances: A narrative review

Kan,

Li,

Zhang

et al. 2023

Brain Circulation

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“…In a retrospective review of 77 mechanical thrombectomy patients, collateral scoring (CS) of cerebral arteries using computed tomography angiography (CTA) inversely correlates with the volume of RAPID cerebral blood flow < 30% (p < 0.001), RAPID Tmax > 6 s (p = 0.011), postintervention stroke volume (p < 0.001), and discharge National Institutes of Health Stroke Scale score (p = 0.023) [62].…”

Section: Perfusion Mapsmentioning

confidence: 99%

How to Improve the Management of Acute Ischemic Stroke by Modern Technologies, Artificial Intelligence, and New Treatment Methods

Zeleňák

Krajina

Meyer

et al. 2021

Life

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Stroke remains one of the leading causes of death and disability in Europe. The European Stroke Action Plan (ESAP) defines four main targets for the years 2018 to 2030. The COVID-19 pandemic forced the use of innovative technologies and created pressure to improve internet networks. Moreover, 5G internet network will be helpful for the transfer and collecting of extremely big databases. Nowadays, the speed of internet connection is a limiting factor for robotic systems, which can be controlled and commanded potentially from various places in the world. Innovative technologies can be implemented for acute stroke patient management soon. Artificial intelligence (AI) and robotics are used increasingly often without the exception of medicine. Their implementation can be achieved in every level of stroke care. In this article, all steps of stroke health care processes are discussed in terms of how to improve them (including prehospital diagnosis, consultation, transfer of the patient, diagnosis, techniques of the treatment as well as rehabilitation and usage of AI). New ethical problems have also been discovered. Everything must be aligned to the concept of “time is brain”.

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“…The cerebral collateral circulation (CCC) is a network of blood vessels designed to preserve cerebral blood flow when primary routes fail [2]. Several recent studies have provided information about the role of collaterals in stroke pathophysiology, and it has been recognised that collateral circulation influences arterial recanalisation, reperfusion, haemorrhagic transformation and neurological outcomes after stroke [3][4][5][6][7]. To date, the CCC has mainly been assessed by using expensive or invasive imaging techniques.…”

Section: Introductionmentioning

confidence: 99%

The relation between plasma miR-126 levels and cerebral collateral circulation in patients with intracranial arterial stenosis

Hao

Wang

Jiang

et al. 2021

Neurol Neurochir Pol.

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Objective. This study aimed to investigate the correlation between the circulating miR-126 regulation pathway and the cerebral collateral circulation (CCC), and to test whether miR-126 could serve as a potential biomarker for CCC formation in patients with intracranial arterial stenosis or occlusion.Material and methods. This single-centre cross-sectional study enrolled patients who underwent cerebral angiography with severe stenosis (≥70%) or occlusion in at least one major intracranial artery. Collateral degree was graded according to the ASITN/SIR classification. The patients were divided into a good CCC group (grade 3-4) or a poor CCC group (grade 0-2). We investigated the plasma levels of miR-126, VEGF, Spred-1 and PIK3R2 by using qRT-PCR, ELISA and Western blot methods, respectively. In addition, we assessed the correlations of plasma miR-126 with VEGF, Spred-1, PIK3R2 and ASITN/SIR grade using the Spearman correlation test and investigated its predictive power for CCC status by using the receiver operating characteristic curve.Results. A total of 68 patients were enrolled (44 with good CCC and 24 with poor CCC). Data showed that plasma miR-126 and VEGF were significantly higher in the good CCC group than in the poor CCC group. Plasma Spred-1 and PIK3R2 level were lower in the good CCC group than in the poor CCC group. In addition, miR-126 and VEGF were positively correlated with ASITN/SIR

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Scoring of Middle Cerebral Artery Collaterals Predicts RAPID CT-Perfusion Analysis and Short-Term Outcomes in Acute Ischemic Stroke Patients Undergoing Thrombectomy

Cited by 5 publications

References 21 publications

No-reflow phenomenon following stroke recanalization therapy: Clinical assessment advances: A narrative review

No-reflow phenomenon following stroke recanalization therapy: Clinical assessment advances: A narrative review

How to Improve the Management of Acute Ischemic Stroke by Modern Technologies, Artificial Intelligence, and New Treatment Methods

The relation between plasma miR-126 levels and cerebral collateral circulation in patients with intracranial arterial stenosis

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