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Keywords = ASITN collateral score

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12 pages, 462 KB  
Article
The Relative Cerebral Blood Volume (rCBV) < 42% Is Independently Associated with Collateral Status in Anterior Circulation Large Vessel Occlusion
by Dhairya A. Lakhani, Aneri B. Balar, Manisha Koneru, Sijin Wen, Burak Berksu Ozkara, Hanzhang Lu, Richard Wang, Meisam Hoseinyazdi, Janet Mei, Risheng Xu, Mehreen Nabi, Ishan Mazumdar, Andrew Cho, Kevin Chen, Sadra Sepehri, Nathan Hyson, Victor Urrutia, Licia Luna, Argye E. Hillis, Jeremy J. Heit, Greg W. Albers, Ansaar T. Rai, Adam A. Dmytriw, Tobias Faizy, Max Wintermark, Kambiz Nael and Vivek S. Yedavalliadd Show full author list remove Hide full author list
J. Clin. Med. 2024, 13(6), 1588; https://doi.org/10.3390/jcm13061588 - 10 Mar 2024
Cited by 12 | Viewed by 2069
Abstract
Background: The pretreatment CT perfusion (CTP) marker the relative cerebral blood volume (rCBV) < 42% lesion volume has recently been shown to predict 90-day functional outcomes; however, studies assessing correlations of the rCBV < 42% lesion volume with other outcomes remain sparse. Here, [...] Read more.
Background: The pretreatment CT perfusion (CTP) marker the relative cerebral blood volume (rCBV) < 42% lesion volume has recently been shown to predict 90-day functional outcomes; however, studies assessing correlations of the rCBV < 42% lesion volume with other outcomes remain sparse. Here, we aim to assess the relationship between the rCBV < 42% lesion volume and the reference standard digital subtraction angiography (DSA)-derived American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology (ASITN) collateral score, hereby referred as the DSA CS. Methods: In this retrospective evaluation of our prospectively collected database, we included acute stroke patients triaged by multimodal CT imaging, including CT angiography and perfusion imaging, with confirmed anterior circulation large vessel occlusion between 1 September 2017 and 1 October 2023. Group differences were assessed using the Student’s t test, Mann–Whitney U test and Chi-Square test. Spearman’s rank correlation and logistic regression analyses were used to assess associations between rCBV < 42% and DSA CS. Results: In total, 222 patients (median age: 69 years, 56.3% female) met our inclusion criteria. In the multivariable logistic regression analysis, taking into account age, sex, race, hypertension, hyperlipidemia, diabetes, atrial fibrillation, prior stroke or transient ischemic attack, the admission National Institute of Health stroke scale, the premorbid modified Rankin score, the Alberta stroke program early CT score (ASPECTS), and segment occlusion, the rCBV < 42% lesion volume (adjusted OR: 0.98, p < 0.05) was independently associated with the DSA CS. Conclusion: The rCBV < 42% lesion volume is independently associated with the DSA CS. Full article
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12 pages, 1103 KB  
Article
The Compensation Index Is Better Associated with DSA ASITN Collateral Score Compared to the Cerebral Blood Volume Index and Hypoperfusion Intensity Ratio
by Dhairya A. Lakhani, Aneri B. Balar, Manisha Koneru, Sijin Wen, Meisam Hoseinyazdi, Cynthia Greene, Risheng Xu, Licia Luna, Justin Caplan, Adam A. Dmytriw, Adrien Guenego, Max Wintermark, Fernando Gonzalez, Victor Urrutia, Judy Huang, Kambiz Nael, Ansaar T. Rai, Gregory W. Albers, Jeremy J. Heit and Vivek S. Yedavalli
J. Clin. Med. 2023, 12(23), 7365; https://doi.org/10.3390/jcm12237365 - 28 Nov 2023
Cited by 24 | Viewed by 2325
Abstract
Background: Pretreatment CT Perfusion (CTP) parameters serve as reliable surrogates of collateral status (CS). In this study, we aim to assess the relationship between the novel compensation index (CI, Tmax > 4 s/Tmax > 6 s) and already established CTP collateral markers, namely [...] Read more.
Background: Pretreatment CT Perfusion (CTP) parameters serve as reliable surrogates of collateral status (CS). In this study, we aim to assess the relationship between the novel compensation index (CI, Tmax > 4 s/Tmax > 6 s) and already established CTP collateral markers, namely cerebral blood volume (CBV) index and Hypoperfusion Intensity Ratio (HIR), with the reference standard American Society of Interventional and Therapeutic Neuroradiology (ASITN) collateral score (CS) on DSA. Methods: In this retrospective study, inclusion criteria were the following: (a) CT angiography confirmed anterior circulation large vessel occlusion from 9 January 2017 to 10 January 2023; (b) diagnostic CT perfusion; and (c) underwent mechanical thrombectomy with documented DSA-CS. Student t-test, Mann–Whitney-U-test and Chi-square test were used to assess differences. Spearman’s rank correlation and logistic regression analysis were used to assess associations. p ≤ 0.05 was considered significant. Results: In total, 223 patients (mean age: 67.8 ± 15.8, 56% female) met our inclusion criteria. The CI (ρ = 0.37, p < 0.001) and HIR (ρ = −0.29, p < 0.001) significantly correlated with DSA-CS. Whereas the CBV Index (ρ = 0.1, p > 0.05) did not correlate with DSA-CS. On multivariate logistic regression analysis taking into account age, sex, ASPECTS, tPA, premorbid mRS, NIH stroke scale, prior history of TIA, stroke, atrial fibrillation, diabetes mellitus, hyperlipidemia, heart disease and hypertension, only CI was not found to be independently associated with DSA-CS (adjusted OR = 1.387, 95% CI: 1.09–1.77, p < 0.01). Conclusion: CI demonstrates a stronger correlation with DSA-CS compared to both the HIR and CBV Index where it may show promise as an additional quantitative pretreatment CS biomarker. Full article
(This article belongs to the Special Issue Advances in the Diagnosis, Treatment, and Prognosis of Acute Stroke)
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