Aims and objectives
Aim of this study was to review the importance of CTA/DSA collaterals on infarct growth and clinical outcome after endovascular thrombectomy (ET) for anterior circulation AIS.
Methods and materials
172 consecutive AIS patients (mean age 57,3y,
April 2009-September 2017),
with anterior circulation AIS,
that undergoing to ET after NCCT/CTA were enrolled.
We assessed the baseline ASPECT on NCCT,
degree of reperfusion after ET (TICI 0-III) with clinical data.
blinded to clinical informations,
evaluated the images in parallel and leptomeningeal score (LMs) was based on scoring pial and lenticulostriate collaterals arteries on CTA.
Collateral flow on CTA and DSA was graded 0 (absent) to 3 (good).
Quadratic weighted κ statistics determined...
On CTA 91/172 (52.90%) had a good (17-20),
54/172 (31.39%) a medium (11-16),
and 27/172 (15.69%) a poor (0-10) LMs while on DSA 110/172 (63.95%) had a good,
49/172 (28.48%) a medium,
and 13/172 (7.55%) a poor (0-10).
TICI III-IIb (OR 27.50; 95%-CI 9.34-81.63) and good collaterals (OR 9.76; 95%-CI 3.28-56.72) were independent predictors of favourable outcome.
The κ-value was 0.27 (93% CI,
The overall proportion of agreement was 23% (95% CI,
On multivariate analysis GCO well matched with good LMs and TICI...
Collateral flow assessment on CTA and LMs alone appear to be as a strong imaging parameter for GCO after ET in anterior AIS patients.
CTA and DSA showed differences,
indicating that these techniques are not alternative for imaging based patient selection.
Chief of Interventional and Vascular Radiology,
0861.429929 Fax: 0861.429309
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