TY - JOUR
T1 - Clinical and Imaging Determinants of Collateral Status in Patients With Acute Ischemic Stroke in MR CLEAN Trial and Registry
AU - Wiegers, Eveline J. A.
AU - Mulder, Maxim J. H. L.
AU - Jansen, Ivo G. H.
AU - Venema, Esmee
AU - Compagne, Kars C. J.
AU - Berkhemer, Olvert A.
AU - Emmer, Bart J.
AU - Marquering, Henk A.
AU - van Es, Adriaan C. G. M.
AU - Sprengers, Marieke E.
AU - van Zwam, Wim H.
AU - van Oostenbrugge, Robert J.
AU - Roos, Yvo B. W. E. M.
AU - Majoie, Charles B. L. M.
AU - Roozenbeek, Bob
AU - Lingsma, Hester F.
AU - Dippel, Diederik W. J.
AU - van der Lugt, Aad
PY - 2020/5
Y1 - 2020/5
N2 - Background and Purpose-Collateral circulation status at baseline is associated with functional outcome after ischemic stroke and effect of endovascular treatment. We aimed to identify clinical and imaging determinants that are associated with collateral grade on baseline computed tomography angiography in patients with acute ischemic stroke due to an anterior circulation large vessel occlusion.Methods-Patients included in the MR CLEAN trial (Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands; n=500) and MR CLEAN Registry (n=1488) were studied. Collateral status on baseline computed tomography angiography was scored from 0 (absent) to 3 (good). Multivariable ordinal logistic regression analyses were used to test the association of selected determinants with collateral status.Results-In total, 1988 patients were analyzed. Distribution of the collateral status was as follows: absent (7%, n=123), poor (32%, n=596), moderate (39%, n=735), and good (23%, n=422). Associations for a poor collateral status in a multivariable model existed for age (adjusted common odds ratio, 0.92 per 10 years [95% CI, 0.886-0.98]), male (adjusted common odds ratio, 0.64 [95% CI, 0.53-0.76]), blood glucose level (adjusted common odds ratio, 0.97 [95% CI, 0.95-1.00]), and occlusion of the intracranial segment of the internal carotid artery with occlusion of the terminus (adjusted common odds ratio 0.50 [95% CI, 0.41-0.61]). In contrast to previous studies, we did not find an association between cardiovascular risk factors and collateral status.Conclusions-Older age, male sex, high glucose levels, and intracranial internal carotid artery with occlusion of the terminus occlusions are associated with poor computed tomography angiography collateral grades in patients with acute ischemic stroke eligible for endovascular treatment.
AB - Background and Purpose-Collateral circulation status at baseline is associated with functional outcome after ischemic stroke and effect of endovascular treatment. We aimed to identify clinical and imaging determinants that are associated with collateral grade on baseline computed tomography angiography in patients with acute ischemic stroke due to an anterior circulation large vessel occlusion.Methods-Patients included in the MR CLEAN trial (Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands; n=500) and MR CLEAN Registry (n=1488) were studied. Collateral status on baseline computed tomography angiography was scored from 0 (absent) to 3 (good). Multivariable ordinal logistic regression analyses were used to test the association of selected determinants with collateral status.Results-In total, 1988 patients were analyzed. Distribution of the collateral status was as follows: absent (7%, n=123), poor (32%, n=596), moderate (39%, n=735), and good (23%, n=422). Associations for a poor collateral status in a multivariable model existed for age (adjusted common odds ratio, 0.92 per 10 years [95% CI, 0.886-0.98]), male (adjusted common odds ratio, 0.64 [95% CI, 0.53-0.76]), blood glucose level (adjusted common odds ratio, 0.97 [95% CI, 0.95-1.00]), and occlusion of the intracranial segment of the internal carotid artery with occlusion of the terminus (adjusted common odds ratio 0.50 [95% CI, 0.41-0.61]). In contrast to previous studies, we did not find an association between cardiovascular risk factors and collateral status.Conclusions-Older age, male sex, high glucose levels, and intracranial internal carotid artery with occlusion of the terminus occlusions are associated with poor computed tomography angiography collateral grades in patients with acute ischemic stroke eligible for endovascular treatment.
KW - collateral circulation
KW - computed tomography angiography
KW - odds ratio
KW - stroke
KW - thrombosis
KW - CT ANGIOGRAPHY
KW - SEX-DIFFERENCES
KW - LEPTOMENINGEAL COLLATERALS
KW - INTRAARTERIAL TREATMENT
KW - CIRCULATION
KW - VESSELS
KW - HYPERGLYCEMIA
KW - PREDICTOR
KW - SEVERITY
KW - OUTCOMES
U2 - 10.1161/STROKEAHA.119.027483
DO - 10.1161/STROKEAHA.119.027483
M3 - Article
C2 - 32279619
VL - 51
SP - 1493
EP - 1502
JO - Stroke
JF - Stroke
SN - 0039-2499
IS - 5
ER -