The single-phase computed tomographic angiography clot burden score is independently associated with digital subtraction angiography derived American Society of Interventional and Therapeutic Neuroradiology collateral score.

Autor:	Lakhani DA; Department of Radiology and Radiological Sciences, Johns Hopkins University, Baltimore, MD, 21287, United States.; Department of Neuroradiology, Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, 26505, United States., Balar AB; Department of Radiology and Radiological Sciences, Johns Hopkins University, Baltimore, MD, 21287, United States., Koneru M; Cooper Medical School of Rowan University, Camden, NJ, 08103, United States., Wen S; Department of Biostatistics, West Virginia University, Morgantown, WV, 26505, United States., Ozkara BB; Department of Radiology, MD Anderson Cancer Center, University of Texas, Houston, TX, 77030, United States., Wang R; Department of Radiology and Radiological Sciences, Johns Hopkins University, Baltimore, MD, 21287, United States., Hoseinyazdi M; Department of Radiology and Radiological Sciences, Johns Hopkins University, Baltimore, MD, 21287, United States., Nabi M; Department of Radiology and Radiological Sciences, Johns Hopkins University, Baltimore, MD, 21287, United States., Mazumdar I; Department of Radiology and Radiological Sciences, Johns Hopkins University, Baltimore, MD, 21287, United States., Cho A; Department of Radiology and Radiological Sciences, Johns Hopkins University, Baltimore, MD, 21287, United States., Chen K; Department of Radiology and Radiological Sciences, Johns Hopkins University, Baltimore, MD, 21287, United States., Sepehri S; Department of Radiology and Radiological Sciences, Johns Hopkins University, Baltimore, MD, 21287, United States., Xu R; Department of Radiology and Radiological Sciences, Johns Hopkins University, Baltimore, MD, 21287, United States., Urrutia V; Department of Radiology and Radiological Sciences, Johns Hopkins University, Baltimore, MD, 21287, United States., Albers GW; Department of Neurology, Stanford University, Stanford, CA, 94305, United States., Rai AT; Department of Neuroradiology, Rockefeller Neuroscience Institute, West Virginia University, Morgantown, WV, 26505, United States., Yedavalli VS; Department of Radiology and Radiological Sciences, Johns Hopkins University, Baltimore, MD, 21287, United States.
Jazyk:	angličtina
Zdroj:	The British journal of radiology [Br J Radiol] 2024 Dec 01; Vol. 97 (1164), pp. 1959-1964.
DOI:	10.1093/bjr/tqae181
Abstrakt:	Objectives: The variation in quality and quantity of collateral status (CS) is in part responsible for a wide variability in extent of neural damage following acute ischemic stroke from large vessel occlusion (AIS-LVO). Single-phase CTA based clot burden score (CBS) is a promising marker in estimating CS. The aim of this study is to assess the relationship of pretreatment CTA based CBS with the reference standard Digital subtraction angiography (DSA) based American Society of Interventional and Therapeutic Neuroradiology (ASITN) CS. Methods: In this retrospective study, inclusion criteria were as follows: (1) Anterior circulation LVO confirmed on CTA from January 9, 2017 to January 10, 2023; (2) diagnostic CTA; and (3) underwent mechanical thrombectomy with documented DSA CS. Spearman's rank correlation analysis, multivariate logistic regression and ROC analysis was performed to assess the correlation of CTA CBS with DSA CS. P ≤ .05 was considered significant. Results: 292 consecutive patients (median age = 68 years; 56.2% female) met our inclusion criteria. CTA CBS and DSA CS showed significant positive correlation (ρ = 0.51, P < .001). On multivariate logistic regression analysis CBS was found to be independently associated with DSA CS (adjusted OR = 1.83, P < .001, 95% CI: 1.54-2.19), after adjusting for age, sex, race, hyperlipidemia, hypertension, diabetes, prior stroke or transient ischemic attack, atrial fibrillation, premorbid mRS, admission NIH stroke scale, and ASPECTS. ROC analysis of CBS in predicting good DSA CS showed AUC of 0.76 (P < .001; 95% CI: 0.68-0.82). CBS threshold of > 6 has 84.6% sensitivity and 42.3% specificity in predicting good DSA CS. Conclusion: CTA CBS is independently associated with DSA CS and serves as a valuable supplementary tool for CS estimation. Further research is necessary to enhance our understanding of the role of CTA CBS in clinical decision-making for patients with AIS-LVO. Advances in Knowledge: CBS by indirectly estimating CS has shown to predict outcomes in AIS-LVO patients. No studies report association of CBS with reference standard DSA. In this study we further establish CBS as an independent marker of CS. (© The Author(s) 2024. Published by Oxford University Press on behalf of the British Institute of Radiology. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
Databáze:	MEDLINE
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