Effect of the interaction between recanalization and collateral circulation on functional outcome in acute ischaemic stroke

Salvatore Mangiafico, Valentina Saia, Patrizia Nencini, Ilaria Romani, Vanessa Palumbo, Giovanni Pracucci, Arturo Consoli, Andrea Rosi, Leonardo Renieri, Sergio Nappini, Nicola Limbucci, Domenico Inzitari, Gian Franco Gensini

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Identification of patients with acute ischaemic stroke who could most benefit from arterial recanalization after endovascular treatment remains an unsettled issue. Although several classifications of collateral circulation have been proposed, the clinical role of collaterals is still debated. We evaluated the effect of the collateral circulation in relation to recanalization as a predictor of clinical outcome. Data were prospectively collected from 103 patients consecutively treated for proximal middle cerebral or internal carotid artery occlusion. The collateral circulation was evaluated with a novel semiquantitative-qualitative score, the Careggi collateral score (CCS), in six grades. Both CCS and recanalization grades (TICI) were analysed in relation to clinical outcome. A statistical analysis was performed to evaluate the effect of interaction between recanalization and collateral circulation on clinical outcome. Out of the 103 patients, 37 (36.3%) had poor collaterals, and 65 (63.7%) had good collaterals. Patients with good collaterals had lower basal National Institute of Health Stroke Scale (NIHSS), more distal occlusion, smaller lesions at 24h CT scan and better functional outcome. After multivariate analysis, the interaction between recanalization and collateral grades was significantly stronger as a predictor of good outcome (OR 6.87, 95% CI 2.11-22.31) or death (OR 4.66, 95%CI 1.48-14.73) compared to the effect of the single variables. Collaterals showed an effect of interaction with the recanalization grade in determining a favourable clinical outcome. Assessment of the collateral circulation might help predict clinical results after recanalization in patients undergoing endovascular treatment for acute ischaemic stroke.

Original languageEnglish
Pages (from-to)704-714
Number of pages11
JournalInterventional Neuroradiology
Volume20
Issue number6
DOIs
Publication statusPublished - Nov 1 2014

Fingerprint

Collateral Circulation
Stroke
National Institutes of Health (U.S.)
Internal Carotid Artery
Multivariate Analysis
Therapeutics

Keywords

  • Acute stroke
  • Acute stroke intervention
  • Angiography
  • Collaterals
  • Endovascular treatment
  • Outcome

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine

Cite this

Effect of the interaction between recanalization and collateral circulation on functional outcome in acute ischaemic stroke. / Mangiafico, Salvatore; Saia, Valentina; Nencini, Patrizia; Romani, Ilaria; Palumbo, Vanessa; Pracucci, Giovanni; Consoli, Arturo; Rosi, Andrea; Renieri, Leonardo; Nappini, Sergio; Limbucci, Nicola; Inzitari, Domenico; Gensini, Gian Franco.

In: Interventional Neuroradiology, Vol. 20, No. 6, 01.11.2014, p. 704-714.

Research output: Contribution to journalArticle

Mangiafico, S, Saia, V, Nencini, P, Romani, I, Palumbo, V, Pracucci, G, Consoli, A, Rosi, A, Renieri, L, Nappini, S, Limbucci, N, Inzitari, D & Gensini, GF 2014, 'Effect of the interaction between recanalization and collateral circulation on functional outcome in acute ischaemic stroke', Interventional Neuroradiology, vol. 20, no. 6, pp. 704-714. https://doi.org/10.15274/INR-2014-10069
Mangiafico, Salvatore ; Saia, Valentina ; Nencini, Patrizia ; Romani, Ilaria ; Palumbo, Vanessa ; Pracucci, Giovanni ; Consoli, Arturo ; Rosi, Andrea ; Renieri, Leonardo ; Nappini, Sergio ; Limbucci, Nicola ; Inzitari, Domenico ; Gensini, Gian Franco. / Effect of the interaction between recanalization and collateral circulation on functional outcome in acute ischaemic stroke. In: Interventional Neuroradiology. 2014 ; Vol. 20, No. 6. pp. 704-714.
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AU - Mangiafico, Salvatore

AU - Saia, Valentina

AU - Nencini, Patrizia

AU - Romani, Ilaria

AU - Palumbo, Vanessa

AU - Pracucci, Giovanni

AU - Consoli, Arturo

AU - Rosi, Andrea

AU - Renieri, Leonardo

AU - Nappini, Sergio

AU - Limbucci, Nicola

AU - Inzitari, Domenico

AU - Gensini, Gian Franco

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KW - Angiography

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KW - Endovascular treatment

KW - Outcome

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