Article Figures & Data
Figures
- Fig 1.
Scoring of the anatomic extent of pial collateral blood flow from the ACA territory to the MCA territory during occlusion of the M1 segment. Scoring corresponds to the angiographically visible retrograde reconstitution of the MCA segments on the delayed venous phase. Each color is depicts the furthest extent of retrograde opacification depicted on anteroposterior cerebral angiograms for each pial collateral score.
- Fig 2.
Anteroposterior (A and C) and lateral (B and C) images from a left internal carotid artery angiogram obtained during the early (A and B) and delayed angiographic phases (C and D) in a patient with acute ischemic stroke due to occlusion at the M1 segment (arrow). Note the retrograde opacification of the MCA branches via pial collateral vessels extending from the ACA (arrowheads). Because there is reverse opacification of the MCA extending to the distal M1 segment, a pial collateral formation score of 1 was assigned.
Tables
- TABLE 1:
Infarct volumes (cm3) distributed according to pial collateral score and recanalization result
Collateral Score Completea Recanalization Mean (σ, n) Partial and Nob Recanalization Mean (σ, n) Total Mean (σ, n) 1 2.53 (2.92, 12) 68.55 (53.59, 15) 39.23 (51.67, 27) 2 32.47 (12.90, 3) 41.93 (25.09, 6) 38.78 (21.38, 9) 3 81.66 (31.13, 5) 122.04 (54.83, 5) 101.85 (47.11, 10) 4 and 5 154.28 (136.04, 4) 392.9 (125.209, 3) 256.54 (175.35, 7) 1 and 2 8.52 (13.57, 15) 60.98 (48.17, 21) 39.12 (45.69, 36) 3–5 113.93 (94.27, 9) 223.61 (160.78, 8) 165.55 (137.61, 17) Total 48.05 (76.95, 24) 105.84 (116.58, 29) 79.67 (103.83, 53) a P = .003, Wilcoxon rank sum test for statistically significant increase in infarct volume with increase in pial collateral score.
b P =.0067, Wilcoxon rank sum test for statistically significant increase in infarct volume with increase in pial collateral score.
- TABLE 2:
Clinical outcome (presentation NIHSS, change in NIHSS, discharge NIHSS, and modified Rankin) distribution according to pial collateral score and recanalization
Pial Collateral Score Recanalization No. Presentation NIHSS Score Median (Range) Change in NIHSS Score Median (Range) Discharge NIHSS Score Median (Range) Discharge Modified Rankin Scale Score Median (Range) 1 Complete 12 13.5 (4–23) 9.5 (0–15) 1.5 (0–19) 1.5 (0.5) Partial/none 15 11 (5–30) 2 (−12–11) 10 (0–30) 4 (0–5) 2 Complete 3 16 (14–16) 12 (10–16) 2 (0–6) 2 (0–3) Partial/none 6 8.5 (5–21) 0 (−6–6) 10 (3–20) 4 (1–5) 3 Complete 5 16 (12–21) 9 (−10–15) 6 (3–22) 3 (1–5) Partial/none 5 17 (15–22) 5 (1–9) 14 (8–18) 4 (4–4) 4 and 5 Complete 4 13.5 (7–26) 1 (−16–5) 10.5 (6–42) 4.5 (4–6) Partial/none 3 19 (17–29) 0 (−25–4) 25 (19–42) 5 (4–6) Total Complete 24 15 (4–26) 9 (−16–16) 5 (0–42) 3 (0–6) Partial/none 29 15 (0–30) 2 (−25–11) 11 (0–42) 4 (0–6) - TABLE 3:
Infarct volume (cm3) distribution according to pial collateral score, occlusion site, and recanalization
Collateral Score Complete Recanalization Partial/No Recanalization Combined Proximal Distal Proximal Distal Proximal Distal Mean (σ, n) Mean (σ, n) Mean (σ, n) Mean (σ, n) Mean (σ, n) Mean (σ, n) 1 and 2 *9.4 †6.2 ‡68.3 a49.2 41.3 34.83 (14.7, 11) (11.3, 4) (50.7, 13) (44.4, 8) (48.3, 24) (41.7, 12) 3–5 *153.0 †82.7 ‡247.7 a55.1 213.3 78.1 (66.7, 4) (40.00, 5) (157.3, 7) (na, 1) (149.9, 11) (38.4, 6) Total 47.7 48.7 131.1 49.8 95.3 49.2 (91.1, 15) (50.1, 9) (131.0, 20) (41.5, 9) (121.4, 35) (44.7, 18) a Unable to prove statistical significance.
* P = .0040, Wilcoxon rank sum test.
† P = .0139, Wilcoxon rank sum test.
‡ P = .0023, Wilcoxon rank sum test.
- TABLE 4:
Linear regression analysis model performed with significant predictive factors for infarct volume (age per year, high collateral score, distal occlusion site, and complete recanalization)
Predictive Factor Estimatea Standard Error t ratio P > |t| Age per year 1.907 0.66 2.88 0.0059 High collateral score 130.73 21.21 6.16 <0.0001 Distal occlusion site −46.53 20.80 −2.24 0.030 Complete recanalization −72.49 20.80 −3.84 0.0007 Intercept 45.71 50.72 0.90 0.37 Note.—F ratio, 15.43; P > F < 0.0001; root square = 0.563; root mean square error = 71.48.
a Estimates indicate change in infarct volume based on indicated predictive factors. For example, high collateral score (3–5) is estimated to increase infarct value by 130.73 cm3.
- TABLE 5:
Linear regression analysis model performed only with significant predictive factors for discharge NIHSS score (age per year, high collateral score, and complete recanalization)
Predictive Factor Estimate Standard Error t ratio P > |t| Age per year 0.247 0.068 3.63 .0007 High collateral score 7.73 2.18 3.54 .0009 Complete recanalization 7.53 2.05 3.68 .0006 Intercept 3.00 4.95 0.61 .547 Note.—NIHSS was considered as a continuous variable for the purpose of this analysis.
- TABLE 6:
Multivariate logistic regression analysis model for poor outcome (modified Rankin scale score > 2) performed with predictive factors (age per year, high collateral score, and complete recanalization)
Predictive Factor Estimate Standard Error χ2 P > χ2 Age per year −0.0620 0.0306 4.10 .0429 High collateral score 3.27 1.299 6.33 .0119 Complete recanalization 2.65 0.890 8.88 .0029 Intercept −1.019 1.87 0.30 .586 Note.—Whole model test: R2 = 0.3476; P < .0001.
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