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Relative Cerebral Blood Flow As an Indirect Imaging Surrogate in Patients With Anterior Circulation Large Vessel Occlusion and Association of Baseline Characteristics With Poor Collateral Status Publisher Pubmed



Salim HA1 ; Hamam O2 ; Parilday G3 ; Moustafa RA4 ; Ghandour S2 ; Rutgers M5 ; Sharara M6 ; Cho A7 ; Mazumdar I7 ; Radmard M8 ; Shin C9 ; Montes D10 ; Malhotra A11 ; Romero JM12 Show All Authors
Authors
  1. Salim HA1
  2. Hamam O2
  3. Parilday G3
  4. Moustafa RA4
  5. Ghandour S2
  6. Rutgers M5
  7. Sharara M6
  8. Cho A7
  9. Mazumdar I7
  10. Radmard M8
  11. Shin C9
  12. Montes D10
  13. Malhotra A11
  14. Romero JM12
  15. Yedavalli V1
Show Affiliations
Authors Affiliations
  1. 1. Johns Hopkins University, Baltimore, MD, United States
  2. 2. Harvard Medical School, Boston, MA, United States
  3. 3. Ankara University Faculty of Medicine, Ankara, Turkey
  4. 4. Rutgers University School Sciences, New Brunswick, NJ, United States
  5. 5. Rutgers University School of Arts and Sciences, New Brunswick, NJ, United States
  6. 6. Medical Collage of Georgia at Augusta University, Augusta, GA, United States
  7. 7. Johns Hopkins University School of Medicine, Baltimore, MD, United States
  8. 8. Tehran University of Medical Sciences, Tehran, Iran
  9. 9. Lahey Hospital and Medical Center, Burlington, MA, United States
  10. 10. University of Colorado, Anschutz Medical Campus, Aurora, CA, United States
  11. 11. Yale School of Medicine, New Haven, CT, United States
  12. 12. Massachusetts General Hospital, Boston, MA, United States

Source: Journal of the American Heart Association Published:2024


Abstract

BACKGROUND: In acute ischemic stroke (AIS), collateral status (CS) is an important predictor of favorable outcomes in patients with AIS. Among quantitative cerebral perfusion parameters, relative cerebral blood flow (rCBF) is considered an accurate perfusion-based indicator of CS. This study investigated the relationship between admission laboratory values, baseline characteristics, and CS as assessed by rCBF in patients with AIS-large vessel occlusion. METHODS AND RESULTS: In this retrospective multicenter study, consecutive patients presenting with AIS secondary to anterior circulation large vessel occlusion who underwent pretreatment computed tomography perfusion were included. The computed tomography perfusion data processed by RAPID (IschemaView, Menlo Park, CA) generated the rCBF. Binary logistic regression models assessed the relationship between patients’ baseline characteristics, admission laboratory values, and poor CS. The primary outcome measure was the presence of poor CS, which was defined as rCBF <38% at a lesion size ≥27 mL. Between January 2017 and September 2022, there were 221 consecutive patients with AIS-large vessel occlusion included in our study (mean age 67.0±15.8 years, 119 men [53.8%]). Logistic regression showed that male sex (odds ratio [OR], 2.98 [1.59–5.59]; P=0.001), chronic kidney disease (OR, 5.18 [2.44–11.0]; P<0.001), admission National Institutes of Health Stroke Scale score ≥12 (OR, 5.17 [2.36–11.36]; P<0.001), and systolic blood pressure <140 (OR, 2.00 [1.07–3.76]; P=0.030) were associated with poor CS. CONCLUSIONS: Higher stroke severity on admission with National Institutes of Health Stroke Scale score ≥12, systolic blood pressure <140, chronic kidney disease, and male sex are statistically significantly associated with poor CS in patients with AIS due to anterior circulation large vessel occlusion as defined by rCBF <38%. © 2024 The Author(s).
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