Good cerebral collateral circulation is associated with favorable functional outcomes following EVT. Can a comprehensive cerebral collateral cascade (CCC) analysis help predict clinical and radiological outcomes in patients treated with EVT?
A study by Dr. Tobias Djamsched Faizy and co-authors, published in Neurology, used multiparametric CT imaging to assess the CCC of LVO patients that underwent thrombectomy.
This retrospective, multicenter, cohort study included large vessel occlusion patients treated with thrombectomy at two comprehensive hospitals, University Medical Center, Hamburg-Eppendorf, Germany, and Standard University Hospital, between January 2013 and December 2019.
A favorable CCC profile can predict good functional outcomes in large vessel occlusion patients undergoing thrombectomy.
Patients with favorable CCC profiles had considerably lower final infarct volumes.
The perfusion images were analyzed with Rapid CTP.
Ischemic core was defined as tissue volume with at least 70% reduced cerebral blood flow relative to the healthy contralateral hemisphere.
The Alberta Stroke Program Early CT Score (ASPECTS) was determined on pre-treatment head non-contrast CT scans.
Study groups and key findings
There were 176 patients with a favorable CCC profile, 126 with an unfavorable CCC profile, and 345 with mixed CCC profiles.
Pivotal trials helped establish the role of endovascular thrombectomy (EVT) treatment for selected ischemic stroke patients with large vessel occlusions. However, not all patients undergoing EVT receive functional independence.