Cerebral collateral cascade associated with infarct growth rate in ischemic stroke patients undergoing endovascular treatment

IF 3.3 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology Pub Date : 2025-09-14 DOI:10.1016/j.ejrad.2025.112418

Liping Huang , Hongfa Zhang , Wenze Li , Chen Gong , Shuyu Jiang , Zhipeng Li , Jinxian Yuan , Tao Xu , Yangmei Chen , Lina Zhang , You Wang

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引用次数: 0

Abstract

Background

Variability in infarct growth rate(IGR) is strongly associated with clinical outcomes in acute ischemic stroke(AIS) patients receiving endovascular treatment(EVT). Recently, the cerebral collateral cascade(CCC) has been shown to be related to imaging and clinical outcomes in AIS. Therefore, we investigated the association between CCC and IGR.

Methods

This was a multicenter retrospective study for AIS patients receiving EVT. IGR was calculated as the ischemic core volume on perfusion computed tomography divided by the time from stroke onset to imaging. Cerebral collateral circulation was assessed using the CCC, which integrated arterial collaterals, tissue-level collaterals, and venous outflow. Multivariable regression was applied to determine factors associated with IGR.

Results

A total of 321 patients were included. The median ischemic core volume was 12.5 mL, and the median IGR was 3.0 mL/h. Multivariable regression analysis showed that compared with patients in the CCC_– group, those in the CCC_mixed(β = −21.43, 95 % CI −35.08 to −7.79; P = 0.002) and CCC₊(β = −34.15, 95 % CI −49.90 to −18.40; P < 0.001) groups had significantly lower IGR. Similar associations were observed in both the elderly and late-window cohorts. Additionally, the NIHSS score at admission and ICA occlusion were significantly associated with IGR (P < 0.05). Furthermore, the diagnostic performance of CCC was significantly better than that of Tan scale (P = 0.001), VO (P < 0.001), or HIR (P = 0.001) as assessed by DeLong’s test.

Conclusion

CCC profiles were strongly associated with infarct progression in AIS patients undergoing EVT. These findings might help us understand the rule of occurrence and development of infarction progression.

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接受血管内治疗的缺血性卒中患者脑侧枝级联与梗死生长速率相关。

背景：在接受血管内治疗（EVT）的急性缺血性卒中（AIS）患者中，梗死生长速率（IGR）的变异性与临床结果密切相关。最近，脑侧枝级联（CCC）已被证明与AIS的影像学和临床结果有关。因此，我们调查了CCC和IGR之间的关系。方法：这是一项针对接受EVT的AIS患者的多中心回顾性研究。IGR的计算方法为灌注计算机断层扫描显示的缺血核体积除以脑卒中发生到成像的时间。使用CCC评估脑侧支循环，包括动脉侧支、组织水平侧支和静脉流出。采用多变量回归确定与IGR相关的因素。结果：共纳入321例患者。中位缺血核体积12.5 mL，中位IGR 3.0 mL/h。多变量回归分析显示，与CCC-组相比，ccc混合组（β = -21.43, 95% CI -35.08 ~ -7.79; P = 0.002）和CCC+组（β = -34.15, 95% CI -49.90 ~ -18.40； P）与EVT后AIS患者的梗死进展密切相关。这些发现可能有助于我们了解梗死发生发展的规律。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Journal of Radiology 医学-核医学

CiteScore

6.70

自引率

3.00%

发文量

398

审稿时长

42 days

期刊介绍： European Journal of Radiology is an international journal which aims to communicate to its readers, state-of-the-art information on imaging developments in the form of high quality original research articles and timely reviews on current developments in the field. Its audience includes clinicians at all levels of training including radiology trainees, newly qualified imaging specialists and the experienced radiologist. Its aim is to inform efficient, appropriate and evidence-based imaging practice to the benefit of patients worldwide.