Impact of cerebral collateral recycle status on clinical outcomes in elderly patients with endovascular stroke treatment
Elderly patients are at high risk of acute ischemic stroke caused by large vessel occlusion (AIS-LVO) and usually suffer disability and fatality from stroke even after receiving endovascular treatment (EVT). Previous studies lacked the knowledge of comprehensive cerebral collateral for elderly patie...
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| Veröffentlicht in: | Journal of neuroradiology 2025-02, Vol.52 (1), p.101236, Article 101236 |
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| creator | Gong, Chen Liu, Jin Huang, Ziyang Jiang, Shuyu Huang, Liping Wang, Zhiyuan Chen, Yankun Yuan, Jinxian Wang, You Xiong, Zhiyu Chen, Yangmei Gong, Siyin Chen, Shengli Xu, Tao |
| description | Elderly patients are at high risk of acute ischemic stroke caused by large vessel occlusion (AIS-LVO) and usually suffer disability and fatality from stroke even after receiving endovascular treatment (EVT). Previous studies lacked the knowledge of comprehensive cerebral collateral for elderly patients. Hence, we explore the role of cerebral collateral recycle (CCR) status in clinical outcomes in a real-world setting among elderly AIS-LVO patients undergoing EVT.
This was a multicenter retrospective cohort study. Computed tomographic angiography (CTA) at admission was applied to evaluate cerebral venous outflow profiles by the Cortical Vein Opacification Score (COVES) and pial arterial collaterals by the Tan scale. According to the status of cerebral collaterals, enrolled patients were divided into the poor, moderate, and favorable CCR groups. The primary outcome was functional independence (90-day modified Rankin Scale score 0–2).
Among 860 AIS-LVO patients receiving EVT, a total of 338 elderly patients were included in the present study after strict screening. Compared with the poor CCR group, the moderate CCR group (31.1 % vs. 10.2 %; adjusted odds ratio[aOR] 3.80; 95 % confidence interval[CI] 1.71–8.44; P = 0.001) and the favorable CCR group (63.3 % vs. 10.2 %; aOR 8.49; 95 % CI 4.02–17.92; P < 0.001) both had a significantly higher rate of functional independence. In subgroup analysis, similar results were found in AIS-LVO patients with older age, large core infarction, or late time window.
The cerebral collateral status in elderly patients with AIS-LVO treated by EVT is a strong predictor of functional outcomes and more robust CCR means better outcomes. |
| doi_str_mv | 10.1016/j.neurad.2024.101236 |
| format | Article |
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This was a multicenter retrospective cohort study. Computed tomographic angiography (CTA) at admission was applied to evaluate cerebral venous outflow profiles by the Cortical Vein Opacification Score (COVES) and pial arterial collaterals by the Tan scale. According to the status of cerebral collaterals, enrolled patients were divided into the poor, moderate, and favorable CCR groups. The primary outcome was functional independence (90-day modified Rankin Scale score 0–2).
Among 860 AIS-LVO patients receiving EVT, a total of 338 elderly patients were included in the present study after strict screening. Compared with the poor CCR group, the moderate CCR group (31.1 % vs. 10.2 %; adjusted odds ratio[aOR] 3.80; 95 % confidence interval[CI] 1.71–8.44; P = 0.001) and the favorable CCR group (63.3 % vs. 10.2 %; aOR 8.49; 95 % CI 4.02–17.92; P < 0.001) both had a significantly higher rate of functional independence. In subgroup analysis, similar results were found in AIS-LVO patients with older age, large core infarction, or late time window.
The cerebral collateral status in elderly patients with AIS-LVO treated by EVT is a strong predictor of functional outcomes and more robust CCR means better outcomes.</description><identifier>ISSN: 0150-9861</identifier><identifier>DOI: 10.1016/j.neurad.2024.101236</identifier><identifier>PMID: 39645026</identifier><language>eng</language><publisher>France: Elsevier Masson SAS</publisher><subject>Acute ischemic stroke ; Aged ; Aged, 80 and over ; Anterior circulation large vessel occlusion ; Cerebral Angiography ; Cerebral collateral ; Cerebrovascular Circulation - physiology ; Collateral Circulation - physiology ; Computed Tomography Angiography ; Elderly patients ; Endovascular Procedures - methods ; Endovascular treatment ; Female ; Humans ; Ischemic Stroke - diagnostic imaging ; Ischemic Stroke - therapy ; Male ; Retrospective Studies ; Stroke - diagnostic imaging ; Treatment Outcome</subject><ispartof>Journal of neuroradiology, 2025-02, Vol.52 (1), p.101236, Article 101236</ispartof><rights>2024 Elsevier Masson SAS</rights><rights>Copyright © 2024 Elsevier Masson SAS. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c241t-a8210b09263e3bab8ca30583750569bad3abb82870c0ed79baeb54980be7c33</cites><orcidid>0009-0008-6560-6157</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0150986124001639$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39645026$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gong, Chen</creatorcontrib><creatorcontrib>Liu, Jin</creatorcontrib><creatorcontrib>Huang, Ziyang</creatorcontrib><creatorcontrib>Jiang, Shuyu</creatorcontrib><creatorcontrib>Huang, Liping</creatorcontrib><creatorcontrib>Wang, Zhiyuan</creatorcontrib><creatorcontrib>Chen, Yankun</creatorcontrib><creatorcontrib>Yuan, Jinxian</creatorcontrib><creatorcontrib>Wang, You</creatorcontrib><creatorcontrib>Xiong, Zhiyu</creatorcontrib><creatorcontrib>Chen, Yangmei</creatorcontrib><creatorcontrib>Gong, Siyin</creatorcontrib><creatorcontrib>Chen, Shengli</creatorcontrib><creatorcontrib>Xu, Tao</creatorcontrib><title>Impact of cerebral collateral recycle status on clinical outcomes in elderly patients with endovascular stroke treatment</title><title>Journal of neuroradiology</title><addtitle>J Neuroradiol</addtitle><description>Elderly patients are at high risk of acute ischemic stroke caused by large vessel occlusion (AIS-LVO) and usually suffer disability and fatality from stroke even after receiving endovascular treatment (EVT). Previous studies lacked the knowledge of comprehensive cerebral collateral for elderly patients. Hence, we explore the role of cerebral collateral recycle (CCR) status in clinical outcomes in a real-world setting among elderly AIS-LVO patients undergoing EVT.
This was a multicenter retrospective cohort study. Computed tomographic angiography (CTA) at admission was applied to evaluate cerebral venous outflow profiles by the Cortical Vein Opacification Score (COVES) and pial arterial collaterals by the Tan scale. According to the status of cerebral collaterals, enrolled patients were divided into the poor, moderate, and favorable CCR groups. The primary outcome was functional independence (90-day modified Rankin Scale score 0–2).
Among 860 AIS-LVO patients receiving EVT, a total of 338 elderly patients were included in the present study after strict screening. Compared with the poor CCR group, the moderate CCR group (31.1 % vs. 10.2 %; adjusted odds ratio[aOR] 3.80; 95 % confidence interval[CI] 1.71–8.44; P = 0.001) and the favorable CCR group (63.3 % vs. 10.2 %; aOR 8.49; 95 % CI 4.02–17.92; P < 0.001) both had a significantly higher rate of functional independence. In subgroup analysis, similar results were found in AIS-LVO patients with older age, large core infarction, or late time window.
The cerebral collateral status in elderly patients with AIS-LVO treated by EVT is a strong predictor of functional outcomes and more robust CCR means better outcomes.</description><subject>Acute ischemic stroke</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Anterior circulation large vessel occlusion</subject><subject>Cerebral Angiography</subject><subject>Cerebral collateral</subject><subject>Cerebrovascular Circulation - physiology</subject><subject>Collateral Circulation - physiology</subject><subject>Computed Tomography Angiography</subject><subject>Elderly patients</subject><subject>Endovascular Procedures - methods</subject><subject>Endovascular treatment</subject><subject>Female</subject><subject>Humans</subject><subject>Ischemic Stroke - diagnostic imaging</subject><subject>Ischemic Stroke - therapy</subject><subject>Male</subject><subject>Retrospective Studies</subject><subject>Stroke - diagnostic imaging</subject><subject>Treatment Outcome</subject><issn>0150-9861</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2025</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kMtOwzAQRb0A0fL4A4S8ZNPiR5ImGySEeEmVWMDesidT4eLExXaA_j2uUliysjVz5o7mEHLO2ZwzXl2t5z0OQbdzwUSxKwlZHZAp4yWbNXXFJ-Q4xjVjgvNCHJGJbKqiZKKaku-nbqMhUb-igAFN0I6Cd04n3H0DwhYc0ph0GiL1PQVnewu55YcEvsNIbU_RtRjclm50stinSL9seqPYt_5TRxicDjkh-HekKaBOXWZOyeFKu4hn-_eEvNzfvd4-zpbPD0-3N8sZiIKnma4FZ4Y1opIojTY1aMnKWi5KVlaN0a3UxtSiXjBg2C5yBU1ZNDUzuAApT8jlmLoJ_mPAmFRnI2C-r0c_RCV5UeWcUoiMFiMKwccYcKU2wXY6bBVnamdZrdVoWe0sq9FyHrvYbxhMh-3f0K_iDFyPAOYrPy0GFSFLAmxttptU6-3_G34Ap9KUkw</recordid><startdate>20250201</startdate><enddate>20250201</enddate><creator>Gong, Chen</creator><creator>Liu, Jin</creator><creator>Huang, Ziyang</creator><creator>Jiang, Shuyu</creator><creator>Huang, Liping</creator><creator>Wang, Zhiyuan</creator><creator>Chen, Yankun</creator><creator>Yuan, Jinxian</creator><creator>Wang, You</creator><creator>Xiong, Zhiyu</creator><creator>Chen, Yangmei</creator><creator>Gong, Siyin</creator><creator>Chen, Shengli</creator><creator>Xu, Tao</creator><general>Elsevier Masson SAS</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0009-0008-6560-6157</orcidid></search><sort><creationdate>20250201</creationdate><title>Impact of cerebral collateral recycle status on clinical outcomes in elderly patients with endovascular stroke treatment</title><author>Gong, Chen ; Liu, Jin ; Huang, Ziyang ; Jiang, Shuyu ; Huang, Liping ; Wang, Zhiyuan ; Chen, Yankun ; Yuan, Jinxian ; Wang, You ; Xiong, Zhiyu ; Chen, Yangmei ; Gong, Siyin ; Chen, Shengli ; Xu, Tao</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c241t-a8210b09263e3bab8ca30583750569bad3abb82870c0ed79baeb54980be7c33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2025</creationdate><topic>Acute ischemic stroke</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Anterior circulation large vessel occlusion</topic><topic>Cerebral Angiography</topic><topic>Cerebral collateral</topic><topic>Cerebrovascular Circulation - physiology</topic><topic>Collateral Circulation - physiology</topic><topic>Computed Tomography Angiography</topic><topic>Elderly patients</topic><topic>Endovascular Procedures - methods</topic><topic>Endovascular treatment</topic><topic>Female</topic><topic>Humans</topic><topic>Ischemic Stroke - diagnostic imaging</topic><topic>Ischemic Stroke - therapy</topic><topic>Male</topic><topic>Retrospective Studies</topic><topic>Stroke - diagnostic imaging</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gong, Chen</creatorcontrib><creatorcontrib>Liu, Jin</creatorcontrib><creatorcontrib>Huang, Ziyang</creatorcontrib><creatorcontrib>Jiang, Shuyu</creatorcontrib><creatorcontrib>Huang, Liping</creatorcontrib><creatorcontrib>Wang, Zhiyuan</creatorcontrib><creatorcontrib>Chen, Yankun</creatorcontrib><creatorcontrib>Yuan, Jinxian</creatorcontrib><creatorcontrib>Wang, You</creatorcontrib><creatorcontrib>Xiong, Zhiyu</creatorcontrib><creatorcontrib>Chen, Yangmei</creatorcontrib><creatorcontrib>Gong, Siyin</creatorcontrib><creatorcontrib>Chen, Shengli</creatorcontrib><creatorcontrib>Xu, Tao</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of neuroradiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gong, Chen</au><au>Liu, Jin</au><au>Huang, Ziyang</au><au>Jiang, Shuyu</au><au>Huang, Liping</au><au>Wang, Zhiyuan</au><au>Chen, Yankun</au><au>Yuan, Jinxian</au><au>Wang, You</au><au>Xiong, Zhiyu</au><au>Chen, Yangmei</au><au>Gong, Siyin</au><au>Chen, Shengli</au><au>Xu, Tao</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of cerebral collateral recycle status on clinical outcomes in elderly patients with endovascular stroke treatment</atitle><jtitle>Journal of neuroradiology</jtitle><addtitle>J Neuroradiol</addtitle><date>2025-02-01</date><risdate>2025</risdate><volume>52</volume><issue>1</issue><spage>101236</spage><pages>101236-</pages><artnum>101236</artnum><issn>0150-9861</issn><abstract>Elderly patients are at high risk of acute ischemic stroke caused by large vessel occlusion (AIS-LVO) and usually suffer disability and fatality from stroke even after receiving endovascular treatment (EVT). Previous studies lacked the knowledge of comprehensive cerebral collateral for elderly patients. Hence, we explore the role of cerebral collateral recycle (CCR) status in clinical outcomes in a real-world setting among elderly AIS-LVO patients undergoing EVT.
This was a multicenter retrospective cohort study. Computed tomographic angiography (CTA) at admission was applied to evaluate cerebral venous outflow profiles by the Cortical Vein Opacification Score (COVES) and pial arterial collaterals by the Tan scale. According to the status of cerebral collaterals, enrolled patients were divided into the poor, moderate, and favorable CCR groups. The primary outcome was functional independence (90-day modified Rankin Scale score 0–2).
Among 860 AIS-LVO patients receiving EVT, a total of 338 elderly patients were included in the present study after strict screening. Compared with the poor CCR group, the moderate CCR group (31.1 % vs. 10.2 %; adjusted odds ratio[aOR] 3.80; 95 % confidence interval[CI] 1.71–8.44; P = 0.001) and the favorable CCR group (63.3 % vs. 10.2 %; aOR 8.49; 95 % CI 4.02–17.92; P < 0.001) both had a significantly higher rate of functional independence. In subgroup analysis, similar results were found in AIS-LVO patients with older age, large core infarction, or late time window.
The cerebral collateral status in elderly patients with AIS-LVO treated by EVT is a strong predictor of functional outcomes and more robust CCR means better outcomes.</abstract><cop>France</cop><pub>Elsevier Masson SAS</pub><pmid>39645026</pmid><doi>10.1016/j.neurad.2024.101236</doi><orcidid>https://orcid.org/0009-0008-6560-6157</orcidid></addata></record> |
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| subjects | Acute ischemic stroke Aged Aged, 80 and over Anterior circulation large vessel occlusion Cerebral Angiography Cerebral collateral Cerebrovascular Circulation - physiology Collateral Circulation - physiology Computed Tomography Angiography Elderly patients Endovascular Procedures - methods Endovascular treatment Female Humans Ischemic Stroke - diagnostic imaging Ischemic Stroke - therapy Male Retrospective Studies Stroke - diagnostic imaging Treatment Outcome |
| title | Impact of cerebral collateral recycle status on clinical outcomes in elderly patients with endovascular stroke treatment |
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