Collaterals at Angiography and Outcomes in the Interventional Management of Stroke (IMS) III Trial
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- David S. Liebeskind
- From UCLA Stroke Center, Los Angeles, CA (D.S.L.); University of Cincinnati, Cincinnati, OH (T.A.T., J.C., P.K., J.P.B.); Medical University of South Carolina, Charleston, SC (L.D.F., S.D.Y., Y.Y.P.); Departments of Clinical Neurosciences and Radiology, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada (A.M.D., M.G., B.K.M.); UPMC Stroke Institute, Pittsburgh, PA (T.G.J.); Department of Neuroradiology, University of Dresden, Dresden, Germany (R.v.K.); University of...
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- Thomas A. Tomsick
- From UCLA Stroke Center, Los Angeles, CA (D.S.L.); University of Cincinnati, Cincinnati, OH (T.A.T., J.C., P.K., J.P.B.); Medical University of South Carolina, Charleston, SC (L.D.F., S.D.Y., Y.Y.P.); Departments of Clinical Neurosciences and Radiology, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada (A.M.D., M.G., B.K.M.); UPMC Stroke Institute, Pittsburgh, PA (T.G.J.); Department of Neuroradiology, University of Dresden, Dresden, Germany (R.v.K.); University of...
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- Lydia D. Foster
- From UCLA Stroke Center, Los Angeles, CA (D.S.L.); University of Cincinnati, Cincinnati, OH (T.A.T., J.C., P.K., J.P.B.); Medical University of South Carolina, Charleston, SC (L.D.F., S.D.Y., Y.Y.P.); Departments of Clinical Neurosciences and Radiology, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada (A.M.D., M.G., B.K.M.); UPMC Stroke Institute, Pittsburgh, PA (T.G.J.); Department of Neuroradiology, University of Dresden, Dresden, Germany (R.v.K.); University of...
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- Sharon D. Yeatts
- From UCLA Stroke Center, Los Angeles, CA (D.S.L.); University of Cincinnati, Cincinnati, OH (T.A.T., J.C., P.K., J.P.B.); Medical University of South Carolina, Charleston, SC (L.D.F., S.D.Y., Y.Y.P.); Departments of Clinical Neurosciences and Radiology, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada (A.M.D., M.G., B.K.M.); UPMC Stroke Institute, Pittsburgh, PA (T.G.J.); Department of Neuroradiology, University of Dresden, Dresden, Germany (R.v.K.); University of...
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- Janice Carrozzella
- From UCLA Stroke Center, Los Angeles, CA (D.S.L.); University of Cincinnati, Cincinnati, OH (T.A.T., J.C., P.K., J.P.B.); Medical University of South Carolina, Charleston, SC (L.D.F., S.D.Y., Y.Y.P.); Departments of Clinical Neurosciences and Radiology, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada (A.M.D., M.G., B.K.M.); UPMC Stroke Institute, Pittsburgh, PA (T.G.J.); Department of Neuroradiology, University of Dresden, Dresden, Germany (R.v.K.); University of...
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- Andrew M. Demchuk
- From UCLA Stroke Center, Los Angeles, CA (D.S.L.); University of Cincinnati, Cincinnati, OH (T.A.T., J.C., P.K., J.P.B.); Medical University of South Carolina, Charleston, SC (L.D.F., S.D.Y., Y.Y.P.); Departments of Clinical Neurosciences and Radiology, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada (A.M.D., M.G., B.K.M.); UPMC Stroke Institute, Pittsburgh, PA (T.G.J.); Department of Neuroradiology, University of Dresden, Dresden, Germany (R.v.K.); University of...
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- Tudor G. Jovin
- From UCLA Stroke Center, Los Angeles, CA (D.S.L.); University of Cincinnati, Cincinnati, OH (T.A.T., J.C., P.K., J.P.B.); Medical University of South Carolina, Charleston, SC (L.D.F., S.D.Y., Y.Y.P.); Departments of Clinical Neurosciences and Radiology, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada (A.M.D., M.G., B.K.M.); UPMC Stroke Institute, Pittsburgh, PA (T.G.J.); Department of Neuroradiology, University of Dresden, Dresden, Germany (R.v.K.); University of...
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- Pooja Khatri
- From UCLA Stroke Center, Los Angeles, CA (D.S.L.); University of Cincinnati, Cincinnati, OH (T.A.T., J.C., P.K., J.P.B.); Medical University of South Carolina, Charleston, SC (L.D.F., S.D.Y., Y.Y.P.); Departments of Clinical Neurosciences and Radiology, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada (A.M.D., M.G., B.K.M.); UPMC Stroke Institute, Pittsburgh, PA (T.G.J.); Department of Neuroradiology, University of Dresden, Dresden, Germany (R.v.K.); University of...
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- Ruediger von Kummer
- From UCLA Stroke Center, Los Angeles, CA (D.S.L.); University of Cincinnati, Cincinnati, OH (T.A.T., J.C., P.K., J.P.B.); Medical University of South Carolina, Charleston, SC (L.D.F., S.D.Y., Y.Y.P.); Departments of Clinical Neurosciences and Radiology, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada (A.M.D., M.G., B.K.M.); UPMC Stroke Institute, Pittsburgh, PA (T.G.J.); Department of Neuroradiology, University of Dresden, Dresden, Germany (R.v.K.); University of...
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- Rebecca M. Sugg
- From UCLA Stroke Center, Los Angeles, CA (D.S.L.); University of Cincinnati, Cincinnati, OH (T.A.T., J.C., P.K., J.P.B.); Medical University of South Carolina, Charleston, SC (L.D.F., S.D.Y., Y.Y.P.); Departments of Clinical Neurosciences and Radiology, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada (A.M.D., M.G., B.K.M.); UPMC Stroke Institute, Pittsburgh, PA (T.G.J.); Department of Neuroradiology, University of Dresden, Dresden, Germany (R.v.K.); University of...
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- Osama O. Zaidat
- From UCLA Stroke Center, Los Angeles, CA (D.S.L.); University of Cincinnati, Cincinnati, OH (T.A.T., J.C., P.K., J.P.B.); Medical University of South Carolina, Charleston, SC (L.D.F., S.D.Y., Y.Y.P.); Departments of Clinical Neurosciences and Radiology, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada (A.M.D., M.G., B.K.M.); UPMC Stroke Institute, Pittsburgh, PA (T.G.J.); Department of Neuroradiology, University of Dresden, Dresden, Germany (R.v.K.); University of...
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- Syed I. Hussain
- From UCLA Stroke Center, Los Angeles, CA (D.S.L.); University of Cincinnati, Cincinnati, OH (T.A.T., J.C., P.K., J.P.B.); Medical University of South Carolina, Charleston, SC (L.D.F., S.D.Y., Y.Y.P.); Departments of Clinical Neurosciences and Radiology, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada (A.M.D., M.G., B.K.M.); UPMC Stroke Institute, Pittsburgh, PA (T.G.J.); Department of Neuroradiology, University of Dresden, Dresden, Germany (R.v.K.); University of...
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- Mayank Goyal
- From UCLA Stroke Center, Los Angeles, CA (D.S.L.); University of Cincinnati, Cincinnati, OH (T.A.T., J.C., P.K., J.P.B.); Medical University of South Carolina, Charleston, SC (L.D.F., S.D.Y., Y.Y.P.); Departments of Clinical Neurosciences and Radiology, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada (A.M.D., M.G., B.K.M.); UPMC Stroke Institute, Pittsburgh, PA (T.G.J.); Department of Neuroradiology, University of Dresden, Dresden, Germany (R.v.K.); University of...
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- Bijoy K. Menon
- From UCLA Stroke Center, Los Angeles, CA (D.S.L.); University of Cincinnati, Cincinnati, OH (T.A.T., J.C., P.K., J.P.B.); Medical University of South Carolina, Charleston, SC (L.D.F., S.D.Y., Y.Y.P.); Departments of Clinical Neurosciences and Radiology, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada (A.M.D., M.G., B.K.M.); UPMC Stroke Institute, Pittsburgh, PA (T.G.J.); Department of Neuroradiology, University of Dresden, Dresden, Germany (R.v.K.); University of...
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- Firas Al Ali
- From UCLA Stroke Center, Los Angeles, CA (D.S.L.); University of Cincinnati, Cincinnati, OH (T.A.T., J.C., P.K., J.P.B.); Medical University of South Carolina, Charleston, SC (L.D.F., S.D.Y., Y.Y.P.); Departments of Clinical Neurosciences and Radiology, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada (A.M.D., M.G., B.K.M.); UPMC Stroke Institute, Pittsburgh, PA (T.G.J.); Department of Neuroradiology, University of Dresden, Dresden, Germany (R.v.K.); University of...
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- Bernard Yan
- From UCLA Stroke Center, Los Angeles, CA (D.S.L.); University of Cincinnati, Cincinnati, OH (T.A.T., J.C., P.K., J.P.B.); Medical University of South Carolina, Charleston, SC (L.D.F., S.D.Y., Y.Y.P.); Departments of Clinical Neurosciences and Radiology, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada (A.M.D., M.G., B.K.M.); UPMC Stroke Institute, Pittsburgh, PA (T.G.J.); Department of Neuroradiology, University of Dresden, Dresden, Germany (R.v.K.); University of...
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- Yuko Y. Palesch
- From UCLA Stroke Center, Los Angeles, CA (D.S.L.); University of Cincinnati, Cincinnati, OH (T.A.T., J.C., P.K., J.P.B.); Medical University of South Carolina, Charleston, SC (L.D.F., S.D.Y., Y.Y.P.); Departments of Clinical Neurosciences and Radiology, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada (A.M.D., M.G., B.K.M.); UPMC Stroke Institute, Pittsburgh, PA (T.G.J.); Department of Neuroradiology, University of Dresden, Dresden, Germany (R.v.K.); University of...
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- Joseph P. Broderick
- From UCLA Stroke Center, Los Angeles, CA (D.S.L.); University of Cincinnati, Cincinnati, OH (T.A.T., J.C., P.K., J.P.B.); Medical University of South Carolina, Charleston, SC (L.D.F., S.D.Y., Y.Y.P.); Departments of Clinical Neurosciences and Radiology, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada (A.M.D., M.G., B.K.M.); UPMC Stroke Institute, Pittsburgh, PA (T.G.J.); Department of Neuroradiology, University of Dresden, Dresden, Germany (R.v.K.); University of...
説明
<jats:sec> <jats:title>Background and Purpose—</jats:title> <jats:p>Endovascular strategies provide unique opportunity to correlate angiographic measures of collateral circulation at the time of endovascular therapy. We conducted systematic analyses of collaterals at conventional angiography on recanalization, reperfusion, and clinical outcomes in the endovascular treatment arm of the Interventional Management of Stroke (IMS) III trial.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods—</jats:title> <jats:p>Prospective evaluation of angiographic collaterals was conducted via central review of subjects treated with endovascular therapy in IMS III (n=331). Collateral grade before endovascular therapy was assessed with the American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology scale, blinded to all other data. Statistical analyses investigated the association between collaterals with baseline clinical variables, angiographic measures of recanalization, reperfusion and clinical outcomes.</jats:p> </jats:sec> <jats:sec> <jats:title>Results—</jats:title> <jats:p> Adequate views of collateral circulation to the ischemic territory were available in 276 of 331 (83%) subjects. Collateral grade was strongly related to both recanalization of the occluded arterial segment ( <jats:italic>P</jats:italic> =0.0016) and downstream reperfusion ( <jats:italic>P</jats:italic> <0.0001). Multivariable analyses confirmed that robust angiographic collateral grade was a significant predictor of good clinical outcome (modified Rankin Scale score ≤2) at 90 days ( <jats:italic>P</jats:italic> =0.0353), adjusted for age, history of diabetes mellitus, National Institutes of Health Stroke Scale strata, and Alberta Stroke Program Early CT Score. The relationship between collateral flow and clinical outcome may depend on the degree of reperfusion. </jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions—</jats:title> <jats:p>More robust collateral grade was associated with better recanalization, reperfusion, and subsequent better clinical outcomes. These data, from the largest endovascular trial to date, suggest that collaterals are an important consideration in future trial design.</jats:p> </jats:sec> <jats:sec> <jats:title>Clinical Trial Registration—</jats:title> <jats:p> URL: <jats:ext-link xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="uri" xlink:href="http://www.clinicaltrials.gov">http://www.clinicaltrials.gov</jats:ext-link> . Unique identifier: NCT00359424. </jats:p> </jats:sec>
収録刊行物
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- Stroke
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Stroke 45 (3), 759-764, 2014-03
Ovid Technologies (Wolters Kluwer Health)
