OBJECTIVES: To establish whether collateral circulation was associated with functional outcome in stroke patients with large infarct size (Alberta Stroke Program Early CT Score [ASPECTS] ≤ 5) undergoing endovascular thrombectomy (EVT) METHODS: Consecutive patients with acute ischemic stroke due to large-vessel occlusion in the anterior circulation and an ASPECTS of ≤ 5 were analyzed. Quantification of collateral circulation was performed using a fluid-attenuated inversion recovery vascular hyperintensity (FVH)-ASPECTS rating system (score ranging from 0 [no FVH] to 7 [FVHs abutting all ASPECTS cortical areas]) by two independent neuroradiologists. Good functional outcome was defined by modified Rankin Scale (mRS) score of 0 to 3 at 3 months. We determined the association between FVH score and clinical outcome using multivariable regression analyses. RESULTS: A total of 139 patients (age, 63.1 ± 20.8 years; men, 51.8%) admitted between March 2012 and December 2017 were included. Good functional outcome (mRS 0-3) was observed in 65 (46.8%) patients, functional independence (mRS 0-2) was achieved in 43 (30.9%) patients, and 33 (23.7%) patients died at 90 days. The median FVH score was 4 (IQR, 3-5). FVH score was independently correlated with good outcome (adjusted OR = 1.41 [95% CI, 1.03-1.92]; p = 0.03 per 1-point increase). CONCLUSIONS: In stroke patients with large-volume infarcts, good collaterals as measured by the FVH-ASPECTS rating system are associated with improved outcomes and may help select patients for reperfusion therapy. KEY POINTS: • Endovascular thrombectomy can allow almost 1 in 2 patients with large infarct cores to achieve good functional outcome (modified Rankin Scale [mRS] of 0-3) and 1 in 3 patients to regain functional independence (mRS 0-2) at 3 months. • The extent of FVH score (as reflected by FLAIR vascular hyperintensity [FVH]-Alberta Stroke Program Early CT Score [ASPECTS] values) is associated with functional outcome at 3 months in this patient group.
OBJECTIVES: To establish whether collateral circulation was associated with functional outcome in stroke patients with large infarct size (Alberta Stroke Program Early CT Score [ASPECTS] ≤ 5) undergoing endovascular thrombectomy (EVT) METHODS: Consecutive patients with acute ischemic stroke due to large-vessel occlusion in the anterior circulation and an ASPECTS of ≤ 5 were analyzed. Quantification of collateral circulation was performed using a fluid-attenuated inversion recovery vascular hyperintensity (FVH)-ASPECTS rating system (score ranging from 0 [no FVH] to 7 [FVHs abutting all ASPECTS cortical areas]) by two independent neuroradiologists. Good functional outcome was defined by modified Rankin Scale (mRS) score of 0 to 3 at 3 months. We determined the association between FVH score and clinical outcome using multivariable regression analyses. RESULTS: A total of 139 patients (age, 63.1 ± 20.8 years; men, 51.8%) admitted between March 2012 and December 2017 were included. Good functional outcome (mRS 0-3) was observed in 65 (46.8%) patients, functional independence (mRS 0-2) was achieved in 43 (30.9%) patients, and 33 (23.7%) patients died at 90 days. The median FVH score was 4 (IQR, 3-5). FVH score was independently correlated with good outcome (adjusted OR = 1.41 [95% CI, 1.03-1.92]; p = 0.03 per 1-point increase). CONCLUSIONS: In stroke patients with large-volume infarcts, good collaterals as measured by the FVH-ASPECTS rating system are associated with improved outcomes and may help select patients for reperfusion therapy. KEY POINTS: • Endovascular thrombectomy can allow almost 1 in 2 patients with large infarct cores to achieve good functional outcome (modified Rankin Scale [mRS] of 0-3) and 1 in 3 patients to regain functional independence (mRS 0-2) at 3 months. • The extent of FVH score (as reflected by FLAIR vascular hyperintensity [FVH]-Alberta Stroke Program Early CT Score [ASPECTS] values) is associated with functional outcome at 3 months in this patient group.
Authors: Benjamin Y Q Tan; Kong Wan-Yee; Prakash Paliwal; Anil Gopinathan; Mahendran Nadarajah; Eric Ting; Narayanaswamy Venketasubramanian; Raymond C S Seet; Bernard P L Chan; Hock L Teoh; Rahul Rathakrishnan; Vijay K Sharma; Leonard L L Yeo Journal: Stroke Date: 2016-08-04 Impact factor: 7.914
Authors: Dezhi Liu; Fabien Scalzo; Neal M Rao; Jason D Hinman; Doojin Kim; Latisha K Ali; Jeffrey L Saver; Wen Sun; Qiliang Dai; Xinfeng Liu; David S Liebeskind Journal: Stroke Date: 2016-09-22 Impact factor: 7.914
Authors: Alexander H Nave; Anna Kufner; Philipp Bücke; Eberhard Siebert; Stefan Kliesch; Ulrike Grittner; Hansjörg Bäzner; Thomas Liebig; Matthias Endres; Jochen B Fiebach; Christian H Nolte; Martin Ebinger; Hans Henkes Journal: Stroke Date: 2018-02-19 Impact factor: 7.914
Authors: Amrou Sarraj; Ameer E Hassan; Sean Savitz; Clark Sitton; James Grotta; Peng Chen; Chunyan Cai; Gary Cutter; Bita Imam; Sujan Reddy; Kaushik Parsha; Deep Pujara; Roy Riascos; Nirav Vora; Michael Abraham; Haris Kamal; Diogo C Haussen; Andrew D Barreto; Maarten Lansberg; Rishi Gupta; Gregory W Albers Journal: JAMA Neurol Date: 2019-10-01 Impact factor: 18.302
Authors: Bruce C V Campbell; Charles B L M Majoie; Gregory W Albers; Bijoy K Menon; Nawaf Yassi; Gagan Sharma; Wim H van Zwam; Robert J van Oostenbrugge; Andrew M Demchuk; Francis Guillemin; Philip White; Antoni Dávalos; Aad van der Lugt; Kenneth S Butcher; Aboubaker Cherifi; Henk A Marquering; Geoffrey Cloud; Juan M Macho Fernández; Jeremy Madigan; Catherine Oppenheim; Geoffrey A Donnan; Yvo B W E M Roos; Jai Shankar; Hester Lingsma; Alain Bonafé; Hélène Raoult; María Hernández-Pérez; Aditya Bharatha; Reza Jahan; Olav Jansen; Sébastien Richard; Elad I Levy; Olvert A Berkhemer; Marc Soudant; Lucia Aja; Stephen M Davis; Timo Krings; Marie Tisserand; Luis San Román; Alejandro Tomasello; Debbie Beumer; Scott Brown; David S Liebeskind; Serge Bracard; Keith W Muir; Diederik W J Dippel; Mayank Goyal; Jeffrey L Saver; Tudor G Jovin; Michael D Hill; Peter J Mitchell Journal: Lancet Neurol Date: 2018-11-06 Impact factor: 44.182