The Effect Of Collateral Circulation On Short-term Prognosis In Patients With Acute Ischemic Stroke

Purpose—To investigate the collateral circulation in patients with acute ischemic stroke and its effect on neurological deficit status and short-term prognosis at admission.Methods—A total of 182 patients with acute ischemic stroke who were admitted to hospital within 24 hours and had head and neck CT angiography(CTA)within 3 days of onset were typed according to OCSP and assessed for grade 1 and grade 2 collaterals with CTA.The circulatory status was recorded at the National Institutes of Health Stroke Scale(NIHSS)score on the admission and the modified Rankin scale(mRS)score at 1 month of onset,and the collateral circulation status of patients with acute ischemic stroke in different subtypes was compared.The effect of neurological impairment and short-term prognosis on admission,and the influencing factors of the formation of collateral circulation.Results—Of the 182 patients included in the study,4 were complete anterior circulation infarction(TACI),2 were collateral circulation(50%),76 were partial anterior circulation infarction(PACI),and 52 were collateral circulation(68.4%);32 patients with posterior circulation infarction(POCI)had 10 patients(31.3%)with collateral circulation;70 patients with lacunar infarction(LACI)had 25 patients(35.7%)with collateral circulation.The distribution of collateral circulation in each subtype was statistically different(P<0.001),and the proportion of PACI-type collateral circulation was the highest(68.4%).Patients with collateral circulation had significantly different NIHSS scores compared to those without collateral circulation.The LAHS and PACI subtypes had collateral circulation with a lower NIHSS score(P<0.05).The proportion of patients with collateral circulation who had a good short-term prognosis was higher than those without collateral circulation(P < 0.001),and those with a collateral circulation of the PACI subtype had a better short-term prognosis(P <0.001).Among the factors affecting the formation of collateral circulation,the probability of the formation of collateral circulation in persons with a history of smoking was 0.081 times that of non-smokers,and the low-density lipoprotein value was higher in patients with non-formation of collateral circulation,with intracranial vascular stenosis.Patients had a higher proportion of collateral circulation than patients without vascular stenosis(all P<0.05).Conclusions—In patients with acute ischemic stroke of OCSP subtypes,the formation of collateral circulation of PACI subtypes is the most common;patients with collateral circulation have lower NIHSS scores,milder neurological deficits,and acute collateral circulation.Patients with ischemic stroke have a better short-term prognosis with less disability than patients without collateral circulation.Influencing factors of collateral circulation,intracranial vascular stenosis promotes the formation of collateral circulation,smoking,and low-density lipoprotein affect The disadvantages of collateral circulation formation.