Influence of leptomeningeal collateral pattern on the prognostic value of mismatch in acute anterior circulation stroke

J Comput Assist Tomogr. 2015 Mar-Apr;39(2):213-6. doi: 10.1097/RCT.0000000000000204.

Abstract

Objective: This study aimed to investigate whether and to what degree leptomeningeal collateral flow as detected on angiography influences the prognostic value of computed tomography perfusion-estimated mismatch in interventional treatment of acute anterior circulation stroke.

Methods: Thirty-eight consecutive patients with acute anterior circulation stroke who received interventional neuroradiologic treatment were assigned one of 2 groups depending on the patient's degree of collateral flow (18 patients with poor collaterals, 20 patients with high degree collaterals) according to the American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology grading system. In a multiregression model, we investigated a possible interaction between 2 independent variables mismatch ratio and degree of collateral flow using a "centered" variable approach.

Results: The mismatch ratio per se showed a significant correlation with final clinical outcome (β coefficient, -0.79; P = 0.02); whereas, there was no interaction shown between mismatch degree of collateral flow (β coefficient, 0.54; P = 0.1).

Conclusions: This study suggests that the predictive value of computed tomography perfusion-estimated mismatch is not influenced by the degree of leptomeningeal collateral flow.

MeSH terms

  • Aged
  • Cerebrovascular Circulation*
  • Female
  • Humans
  • Male
  • Meninges / blood supply*
  • Prognosis
  • Retrospective Studies
  • Stroke / diagnostic imaging
  • Stroke / physiopathology*
  • Stroke / surgery
  • Thrombectomy
  • Tomography, X-Ray Computed
  • Treatment Outcome