Automated scoring of collaterals, blood pressure, and clinical outcome after endovascular treatment in patients with acute ischemic stroke and large-vessel occlusion
Guisado-Alonso, Daniel (Institut d'Investigació Biomèdica Sant Pau)
Camps-Renom, Pol (Institut d'Investigació Biomèdica Sant Pau)
Delgado Mederos, Raquel (Institut d'Investigació Biomèdica Sant Pau)
Granell, Esther (Unitat de Diagnòstic per la Imatge d'Alta Tecnologia)
Prats-Sánchez, Luis Antonio (Institut d'Investigació Biomèdica Sant Pau)
Martínez-Domeño, Alejandro (Institut d'Investigació Biomèdica Sant Pau)
Guasch-Jiménez, Marina (Institut d'Investigació Biomèdica Sant Pau)
costa, M. Victoria (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Ramos-Pachón, Anna (Institut d'Investigació Biomèdica Sant Pau)
Martí-Fàbregas, Joan (Institut d'Investigació Biomèdica Sant Pau)
Universitat Autònoma de Barcelona

Date:	2022
Abstract:	Introduction: We aimed to determine whether the degree of collateral circulation is associated with blood pressure at admission in acute ischemic stroke patients treated with endovascular treatment and to determine its prognostic value. Methods: We evaluated patients with anterior large vessel occlusion treated with endovascular treatment in a single-center prospective registry. We collected clinical and radiological data. Automated and validated software (Brainomix Ltd. , Oxford, UK) was used to generate the collateral score (CS) from the baseline single-phase CT angiography: 0, filling of ≤10% of the occluded MCA territory; 1, 11-50%; 2, 51-90%; 3, >90%. When dichotomized, we considered that CS was good (CS = 2-3), or poor (CS = 0-1). We performed bivariate and multivariable ordinal logistic regression analysis to predict CS categories in our population. The secondary outcome was to determine the influence of automated CS on functional outcome at 3 months. We defined favorable functional outcomes as mRS 0-2 at 3 months. Results: We included 101 patients with a mean age of 72. 1 ± 13. 1 years and 57 (56. 4%) of them were women. We classified patients into 4 groups according to the CS: 7 patients (6. 9%) as CS = 0, 15 (14. 9%) as CS = 1, 43 (42. 6%) as CS = 2 and 36 (35. 6%) as CS = 3. Admission systolic blood pressure [aOR per 10 mmHg increase 0. 79 (95% CI 0. 68-0. 92)] and higher baseline NIHSS [aOR 0. 90 (95% CI, 0. 84-0. 96)] were associated with a worse CS. The OR of improving 1 point on the 3-month mRS was 1. 63 (95% CI, 1. 10-2. 44) favoring a better CS (p = 0. 016). Conclusion: In acute ischemic stroke patients with anterior large vessel occlusion treated with endovascular treatment, admission systolic blood pressure was inversely associated with the automated scoring of CS on baseline CT angiography. Moreover, a good CS was associated with a favorable outcome.
Grants:	Instituto de Salud Carlos III RD21/0006/0006 Instituto de Salud Carlos III CM18/00065 Instituto de Salud Carlos III CM20/00056 Instituto de Salud Carlos III PI19/00859
Note:	Altres ajuts: Ministerio de Ciencia e Innovación; Fondo Europeo de Desarrollo Regional (FEDER).
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Collateral circulation ; Acute stroke ; Endovascular treatment ; Blood pressure ; Outcome
Published in:	Frontiers in neurology, Vol. 13 (september 2022) , p. 944779, ISSN 1664-2295

DOI: 10.3389/fneur.2022.944779
PMID: 36016546

8 p, 708.2 KB

The record appears in these collections:
Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut de Recerca Sant Pau
Articles > Research articles
Articles > Published articles