Collaterals and outcomes after endovascular treatment in acute large vessel occlusion: Disparity by stroke etiologies.

IF 6.3 2区 医学 Q1 CLINICAL NEUROLOGY
Xinyi Leng, Ximing Nie, Hongyi Yan, Yuesong Pan, Lina Zheng, Yuying Liu, Wanying Duan, Xin Liu, Yufei Wei, Weibin Gu, Xinyi Hou, Thomas W Leung, Zhongrong Miao, David S Liebeskind, Liping Liu
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引用次数: 0

Abstract

Background: Collateral circulation provides compensatory flow to ischemic brain regions in acute large vessel occlusion (LVO), which had been associated with better outcomes after endovascular treatment (EVT).

Aims: We aimed to reveal the pre-EVT collateral status and its associations with outcomes after EVT, in patients with acute LVO with different etiologies.

Methods: Based on a prospective, multicenter registry, we analyzed patients with acute, intracranial anterior-circulation LVO due to large artery atherosclerosis (LAA) and cardioembolism (CE), who underwent EVT within 24 hours. Pre-EVT leptomeningeal collateral status was classified on digital subtraction angiography by ASITN/SIR grading system. Outcomes included good 3-month functional outcome (modified Rankin Scale [mRS] 0-2), 3-month mRS distribution, successful recanalization, early neurological deterioration, symptomatic intracranial hemorrhage (sICH), and 3-month mortality.

Results: Among 805 patients (median age 66 years), 450 and 355 respectively had LVO due to LAA and CE, of whom 57.8% and 56.6% (p=0.742) had good pre-EVT collaterals. In LAA patients, good collaterals were associated with lower risk of sICH (adjusted odds ratio [OR]=0.40; 95% CI 0.17-0.94; p=0.036) but not functional outcomes. In CE patients, good collaterals were associated with a higher chance of good functional outcome (adjusted OR=1.55; 95% CI 0.96-2.51; p=0.072) and lower mRS at 3 months (adjusted common OR=0.64; 95% CI 0.43-0.94; p=0.021). However, there was no significant CE/LAA and collateral status interaction on any outcome.

Conclusions: The study revealed comparable pre-EVT collateral status in patients with LVO due to LAA versus CE who received EVT within 24 hours, but the pre-EVT collaterals may have different protective effects for post-EVT outcomes in these two groups of patients.

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来源期刊
International Journal of Stroke
International Journal of Stroke 医学-外周血管病
CiteScore
13.90
自引率
6.00%
发文量
132
审稿时长
6-12 weeks
期刊介绍: The International Journal of Stroke is a welcome addition to the international stroke journal landscape in that it concentrates on the clinical aspects of stroke with basic science contributions in areas of clinical interest. Reviews of current topics are broadly based to encompass not only recent advances of global interest but also those which may be more important in certain regions and the journal regularly features items of news interest from all parts of the world. To facilitate the international nature of the journal, our Associate Editors from Europe, Asia, North America and South America coordinate segments of the journal.
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