Details

Autor(en) / Beteiligte

• LIEBESKIND, David S
• TOMSICK, Thomas A
• ZAIDAT, Osama O
• HUSSAIN, Syed I
• GOYAL, Mayank
• MENON, Bijoy K
• FIRAS AL ALI
• YAN, Bernard
• PALESCH, Yuko Y
• BRODERICK, Joseph P
• FOSTER, Lydia D
• YEATTS, Sharon D
• CARROZZELLA, Janice
• DEMCHUK, Andrew M
• JOVIN, Tudor G
• KHATRI, Pooja
• VON KUMMER, Ruediger
• SUGG, Rebecca M

Titel

Collaterals at Angiography and Outcomes in the Interventional Management of Stroke (IMS) III Trial

Ist Teil von

• Stroke (1970), 2014-03, Vol.45 (3), p.759-764

Ort / Verlag

Hagerstown, MD: Lippincott Williams & Wilkins

Erscheinungsjahr

2014

Link zum Volltext

Quelle

Alma/SFX Local Collection

Beschreibungen/Notizen

• 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. 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. 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 (P=0.0016) and downstream reperfusion (P<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 (P=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. 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. http://www.clinicaltrials.gov. Unique identifier: NCT00359424.