BACKGROUND: Pre-treatment collateral status may be associated with the rates of successful revascularization in acute ischemic stroke patients receiving endovascular treatment (EVT). We conducted a systematic review and meta-analysis to synthesize relevant evidence currently available. METHODS: Relevant full-text articles published in English since January 1, 2000, reporting associations between collateral status and successful reperfusion and/or recanalization in acute ischemic stroke patients receiving EVT in cohort or case-control studies, or randomized clinical trials, were retrieved through search of PubMed. Study selection, data extraction and study quality assessment were carried out by 2 investigators. Risk ratios (RR) were pooled for good vs. poor collaterals for the outcomes of successful reperfusion and recanalization, based on random-effects models. Subgroup analyses were conducted to explore for potential factors that might interfere with the effects of pre-treatment collateral status on reperfusion by EVT. RESULTS: In total, 27 studies (2,366 subjects) were included in qualitative analysis, among which 24 studies (2,239 subjects) were quantitatively analyzed. Overall, good pre-treatment collaterals significantly increased the rate of both successful reperfusion (RR 1.28, 95% CI 1.17-1.40; p < 0.001) and recanalization (RR 1.23, 95% CI 1.06-1.42; p = 0.006), as compared with poor collaterals. Subgroup analyses revealed that the effects of collateral status on successful reperfusion by EVT might be different between populations with different ethnicities. CONCLUSIONS: Good pre-treatment collaterals may enhance the rates of successful reperfusion and recanalization in EVT for acute ischemic stroke. This may partly explain the favorable effects of good pre-treatment collaterals on clinical outcomes of stroke patients receiving EVT. Thus, it would be valuable to assess the collateral status prior to EVT in acute ischemic stroke. But studies are needed to further verify if the positive effects of good collaterals on revascularization by EVT are restricted to certain subgroups of patients.
BACKGROUND: Pre-treatment collateral status may be associated with the rates of successful revascularization in acute ischemic strokepatients receiving endovascular treatment (EVT). We conducted a systematic review and meta-analysis to synthesize relevant evidence currently available. METHODS: Relevant full-text articles published in English since January 1, 2000, reporting associations between collateral status and successful reperfusion and/or recanalization in acute ischemic strokepatients receiving EVT in cohort or case-control studies, or randomized clinical trials, were retrieved through search of PubMed. Study selection, data extraction and study quality assessment were carried out by 2 investigators. Risk ratios (RR) were pooled for good vs. poor collaterals for the outcomes of successful reperfusion and recanalization, based on random-effects models. Subgroup analyses were conducted to explore for potential factors that might interfere with the effects of pre-treatment collateral status on reperfusion by EVT. RESULTS: In total, 27 studies (2,366 subjects) were included in qualitative analysis, among which 24 studies (2,239 subjects) were quantitatively analyzed. Overall, good pre-treatment collaterals significantly increased the rate of both successful reperfusion (RR 1.28, 95% CI 1.17-1.40; p < 0.001) and recanalization (RR 1.23, 95% CI 1.06-1.42; p = 0.006), as compared with poor collaterals. Subgroup analyses revealed that the effects of collateral status on successful reperfusion by EVT might be different between populations with different ethnicities. CONCLUSIONS: Good pre-treatment collaterals may enhance the rates of successful reperfusion and recanalization in EVT for acute ischemic stroke. This may partly explain the favorable effects of good pre-treatment collaterals on clinical outcomes of strokepatients receiving EVT. Thus, it would be valuable to assess the collateral status prior to EVT in acute ischemic stroke. But studies are needed to further verify if the positive effects of good collaterals on revascularization by EVT are restricted to certain subgroups of patients.
Authors: C Dargazanli; A Consoli; M Barral; J Labreuche; H Redjem; G Ciccio; S Smajda; J P Desilles; G Taylor; C Preda; O Coskun; G Rodesch; M Piotin; R Blanc; B Lapergue Journal: AJNR Am J Neuroradiol Date: 2016-11-03 Impact factor: 3.825
Authors: Yoon-Chul Kim; Jong-Won Chung; Oh Young Bang; Mihee Hong; Woo-Keun Seo; Gyeong-Moon Kim; Eung Yeop Kim; Jin Soo Lee; Ji Man Hong; David S Liebeskind; Jeffrey L Saver Journal: Transl Stroke Res Date: 2022-05-21 Impact factor: 6.829
Authors: Faheem Sheriff; Mariana Diz-Lopes; Ayaz Khawaja; Farzaneh Sorond; Can Ozan Tan; Elsa Azevedo; Maria Angela Franceschini; Henri Vaitkevicius; Karen Li; Andrew Donald Monk; Sarah LaRose Michaud; Steven K Feske; Pedro Castro Journal: Stroke Date: 2019-12-04 Impact factor: 7.914
Authors: A P Jadhav; H-C Diener; A Bonafe; V M Pereira; E I Levy; B W Baxter; T G Jovin; R G Nogueira; D R Yavagal; C Cognard; D D Purcell; B K Menon; R Jahan; J L Saver; M Goyal Journal: AJNR Am J Neuroradiol Date: 2017-10-12 Impact factor: 3.825
Authors: Romain Bourcier; Mayank Goyal; David S Liebeskind; Keith W Muir; Hubert Desal; Adnan H Siddiqui; Diederik W J Dippel; Charles B Majoie; Wim H van Zwam; Tudor G Jovin; Elad I Levy; Peter J Mitchell; Olvert A Berkhemer; Stephen M Davis; Imad Derraz; Geoffrey A Donnan; Andrew M Demchuk; Robert J van Oostenbrugge; Michael Kelly; Yvo B Roos; Reza Jahan; Aad van der Lugt; Marieke Sprengers; Stephane Velasco; Geert J Lycklama À Nijeholt; Wagih Ben Hassen; Paul Burns; Scott Brown; Emmanuel Chabert; Timo Krings; Hana Choe; Christian Weimar; Bruce C V Campbell; Gary A Ford; Marc Ribo; Phil White; Geoffrey C Cloud; Luis San Roman; Antoni Davalos; Olivier Naggara; Michael D Hill; Serge Bracard Journal: JAMA Neurol Date: 2019-04-01 Impact factor: 18.302