Arturo Consoli1, Tommy Andersson2,3, Ake Holmberg3, Luca Verganti4, Andrea Saletti5, Stefano Vallone4, Andrea Zini6, Alfonso Cerase7, Daniele Romano7, Sandra Bracco7, Svetlana Lorenzano8, Enrico Fainardi5, Salvatore Mangiafico1. 1. Interventional Neuroradiology Unit, Careggi University Hospital, Florence, Italy. 2. Departments of Radiology and Neurology, AZ Groeninge, Kortrijk, Belgium. 3. Department of Neuroradiology, Karolinska University Hospital, and Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden. 4. Department of Neuroradiology, Nuovo Ospedale Civile 'S Agostino-Estense', Modena, Italy. 5. Neuroradiology Unit, Azienda Ospedaliero-Universitaria of Ferrara, Cona, Ferrara, Italy. 6. Stroke Unit, Department of Neuroscience, Nuovo Ospedale Civile 'S Agostino-Estense', Modena, Italy. 7. Unit of Neuroimaging and Neurointervention, Policlinico 'Santa Maria alle Scotte,', Siena, Italy. 8. Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy.
Abstract
BACKGROUND: The purpose of this study was to evaluate the correlation between a novel angiographic score for collaterals and CT perfusion (CTP) parameters in patients undergoing endovascular treatment for acute ischemic stroke (AIS). METHODS: 103 patients (mean age 66.7±12.7; 48.5% men) with AIS in the anterior circulation territory, imaged with non-contrast CT, CT angiography, and CTP, admitted within 8 h from symptom onset and treated with any endovascular approach, were retrospectively included in the study. Clinical, neuroradiological data, and all time intervals were collected. Careggi Collateral Score (CCS) was used for angiographic assessment of collaterals and the Alberta Stroke Program Early CT Score (ASPECTS) for semiquantitative analysis of CTP maps. Two centralized core laboratories separately reviewed angiographic data, whereas CT findings were evaluated by an expert neuroradiologist. Univariate and multivariate analysis were performed considering CCS both as an ordinal and a dichotomous variable. RESULTS: 37/103 patients (35.9%) received intravenous tissue plasminogen activator. Median (IQR) ASPECTS was 9 (6-10) for admission CT, 9 (5-10) for cerebral blood volume (CBV) maps, 3 (2-3) for mean transit time maps, 3 (2-4), for cerebral blood flow maps, and 5 (3-7) for CTP mismatch. Univariate analysis showed a significant correlation between CCS and ASPECTS for all CTP parameters. Multivariate analysis confirmed an independent association only between CCS and CBV (p=0.020 when CCS was considered as a dichotomous variable, p=0.026 with ordinal CCS). CONCLUSIONS: A correlation between angiographic assessment of the collateral circulation and CTP seems to be present, suggesting that CCS may provide an indirect evaluation of the infarct core volume to consider for patient selection in AIS. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
BACKGROUND: The purpose of this study was to evaluate the correlation between a novel angiographic score for collaterals and CT perfusion (CTP) parameters in patients undergoing endovascular treatment for acute ischemic stroke (AIS). METHODS: 103 patients (mean age 66.7±12.7; 48.5% men) with AIS in the anterior circulation territory, imaged with non-contrast CT, CT angiography, and CTP, admitted within 8 h from symptom onset and treated with any endovascular approach, were retrospectively included in the study. Clinical, neuroradiological data, and all time intervals were collected. Careggi Collateral Score (CCS) was used for angiographic assessment of collaterals and the Alberta Stroke Program Early CT Score (ASPECTS) for semiquantitative analysis of CTP maps. Two centralized core laboratories separately reviewed angiographic data, whereas CT findings were evaluated by an expert neuroradiologist. Univariate and multivariate analysis were performed considering CCS both as an ordinal and a dichotomous variable. RESULTS: 37/103 patients (35.9%) received intravenous tissue plasminogen activator. Median (IQR) ASPECTS was 9 (6-10) for admission CT, 9 (5-10) for cerebral blood volume (CBV) maps, 3 (2-3) for mean transit time maps, 3 (2-4), for cerebral blood flow maps, and 5 (3-7) for CTP mismatch. Univariate analysis showed a significant correlation between CCS and ASPECTS for all CTP parameters. Multivariate analysis confirmed an independent association only between CCS and CBV (p=0.020 when CCS was considered as a dichotomous variable, p=0.026 with ordinal CCS). CONCLUSIONS: A correlation between angiographic assessment of the collateral circulation and CTP seems to be present, suggesting that CCS may provide an indirect evaluation of the infarct core volume to consider for patient selection in AIS. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Authors: Juan F Arenillas; Elisa Cortijo; Pablo García-Bermejo; Elad I Levy; Reza Jahan; David Liebeskind; Mayank Goyal; Jeffrey L Saver; Gregory W Albers Journal: J Cereb Blood Flow Metab Date: 2017-11-14 Impact factor: 6.200
Authors: M Laflamme; S Carrondo-Cottin; M-M Valdès; D Simonyan; M-È Audet; J-L Gariépy; M-C Camden; C Gariépy; S Verreault; P Lavoie Journal: AJNR Am J Neuroradiol Date: 2022-09-22 Impact factor: 4.966
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