Collateral Score Based On Dynamic CT Angiography Simulating ASITN/SIR Can Predict The Prognosis In Patients With Anterior Circulation Ischemic Stroke After Endovascular Treatment

Objective:Collateral flow is associated with clinical outcome after acute ischemic stroke.DSA and CTperfusion(CTP)-derived dynamic CT angiography(CTA)can both be used to assess the collateral flow.We thus aimed to analyze the relationship between collateral flow based on these two methods and clinical outcome in patients who received endovascular treatment.Methods:We retrospectively reviewed the data of acute ischemic stroke patients with anterior artery occlusion from October 2013 to December 2016 who underwent endovascular treatment in our stroke center.Anterior artery occlusion was diagnosed by the dynamic CTA images which were reconstructed from CTP images.Good outcome was defined as a modified Rankin Scale(mRS)? 2 at 3 months after ischemic stroke.We then assessed the collateral vessels through CTP(CTP-CS)and DSA(DSA-CS),respectively,and analyzed the correlation between the collateral flows and clinical outcome at 3months.Results:Among 42 patients,35(83.3%)acquired recanalization and 18(42.9%)got good outcome.Comparing to patients with poor outcome,the rate of good collateral vessels was higher in good outcome group(CTP-CS:77.8%vs 37.5%,P=0.009;DSA-CS:77.8%vs 37.5%,P=0.009).After adjusting baseline National Institute of Health Stroke Scale(NIHSS)and onset to recanalization time(ORT),good collateral vessels were independently associated with good outcome(CTP-CS:OR=12.525,P=0.037;DSA-CS:OR=11.875,P=0.042).Consistency analysis showed that the two collateral vessels based on CTP and DSA were compariable(Kappa=0.712,P<0.001).Conclusion:Collateral score based on dynamic CT angiographysimulating ASITN/SIR can predict the clinical outcome of acute anterior circulation ischemic stroke patients after endovascular treatment.