Affiliation:
1. Department of Radiology, University of Chicago, USA
2. Department of Radiology, Rush University, USA
3. Department of Radiology, Cleveland Clinic, USA
4. Department of Neurology, The Ohio State University, USA
Abstract
Background Pial arterioles can provide a variable degree of collateral flow to ischemic vascular territories during acute ischemic stroke. This study sought to identify predictive factors of the degree of pial collateral recruitment in acute ischemic stroke. Methods Clinical information and arteriograms from 62 consecutive patients with stroke due to either middle cerebral artery (MCA) M1 segment or internal carotid artery (ICA) terminus occlusion within 6 h following symptom onset were retrospectively reviewed. Pial collaterals were defined based on the extent of reconstitution of the MCA territory. Patients with slow antegrade flow distal to the occlusion site were excluded and no anesthetics were used prior or during angiography. Results were analyzed using multivariate nominal logistic regression. Results Better pial collateral recruitment was associated with proximal MCA versus ICA terminus occlusion ( p = 0.005; odds ratio (OR) = 9.3; 95% confidence interval (CI), 2.16–53.3), lower presenting National Institutes of Health Stroke Scale Score (NIHSSS) ( p = 0.023; OR = 6.51; 95% CI, 1.49–41.7), and lower diastolic blood pressure ( p = 0.0411; OR = 5.05; 95% CI, 1.20–29.2). Age, gender, symptom duration, diabetes, laterality, systolic blood pressure, glucose level, hematocrit, platelet level, and white blood cell count at presentation were not found to have a statistically significant association with pial collateral recruitment. Conclusions Extent of pial collateral recruitment is strongly associated with the occlusion site (MCA M1 segment versus ICA terminus) and less strongly associated with presenting NIHSSS and diastolic blood pressure.
Subject
Clinical Neurology,Radiology Nuclear Medicine and imaging,General Medicine
Cited by
3 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献