CT perfusion and angiographic assessment of pial collateral reperfusion in acute ischemic stroke: the CAPRI study. (22nd January 2016)

• Record Type: Journal Article
• Authors: Consoli, Arturo; Andersson, Tommy; Holmberg, Ake; Verganti, Luca; Saletti, Andrea; Vallone, Stefano; Zini, Andrea; Cerase, Alfonso; Romano, Daniele; Bracco, Sandra; Lorenzano, Svetlana; Fainardi, Enrico; Mangiafico, Salvatore
• Other Names: author non-byline.; Rosi Andrea author non-byline.; Renieri Leonardo author non-byline.; Nappini Sergio author non-byline.; Limbucci Nicola author non-byline.; Bigliardi Guido author non-byline.; Dell'Acqua Maria Luisa author non-byline.; Marcello Onofrio author non-byline.; Borgatti Luca author non-byline.; Borrelli Massimo author non-byline.; Ceruti Stefano author non-byline.; Bernardoni Andrea author non-byline.; Padroni Marina author non-byline.; Tamborino Carmine author non-byline.; De Vito Alessandro author non-byline.; Azzini Cristiano author non-byline.; Capaccioli Leonardo author non-byline.
• Is Part Of: Journal of neurointerventional surgery. Volume 8:Number 12(2016)
• Page Start: 1211
• Page End: 1216
• Publication Date: 2016-01-22
• Subjects: Stroke -- Angiography -- CT perfusion; Nervous system -- Surgery -- Periodicals; Cerebrovascular disease -- Surgery -- Periodicals; 617.48
• DOI: 10.1136/neurintsurg-2015-012155
• Languages: English
• ISSNs: 1759-8478

Abstract

Abstract : Background: The purpose of this study was to evaluate the correlation between a novel angiographic score for collaterals and CT perfusion (CTP) parameters in patients undergoing endovascular treatment for acute ischemic stroke (AIS). Methods: 103 patients (mean age 66.7±12.7; 48.5% men) with AIS in the anterior circulation territory, imaged with non-contrast CT, CT angiography, and CTP, admitted within 8 h from symptom onset and treated with any endovascular approach, were retrospectively included in the study. Clinical, neuroradiological data, and all time intervals were collected. Careggi Collateral Score (CCS) was used for angiographic assessment of collaterals and the Alberta Stroke Program Early CT Score (ASPECTS) for semiquantitative analysis of CTP maps. Two centralized core laboratories separately reviewed angiographic data, whereas CT findings were evaluated by an expert neuroradiologist. Univariate and multivariate analysis were performed considering CCS both as an ordinal and a dichotomous variable. Results: 37/103 patients (35.9%) received intravenous tissue plasminogen activator. Median (IQR) ASPECTS was 9 (6–10) for admission CT, 9 (5–10) for cerebral blood volume (CBV) maps, 3 (2–3) for mean transit time maps, 3 (2–4), for cerebral blood flow maps, and 5 (3–7) for CTP mismatch. Univariate analysis showed a significant correlation between CCS and ASPECTS for all CTP parameters. Multivariate analysis confirmed an independent association only between CCS and CBV (p=0.020 when CCS was considered as a dichotomous variable, p=0.026 with ordinal CCS). Conclusions: A correlation between angiographic assessment of the collateral circulation and CTP seems to be present, suggesting that CCS may provide an indirect evaluation of the infarct core volume to consider for patient selection in AIS.