RT Journal Article
SR Electronic
T1 The Cortical Vein Opacification Score (COVES) Is Independently Associated with DSA ASITN Collateral Score
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 921
OP 928
DO 10.3174/ajnr.A8601
VO 46
IS 5
A1 Lakhani, Dhairya A.
A1 Balar, Aneri B.
A1 Ali, Subtain
A1 Khan, Musharaf
A1 Salim, Hamza
A1 Koneru, Manisha
A1 Wen, Sijin
A1 Wang, Richard
A1 Mei, Janet
A1 Hillis, Argye E.
A1 Heit, Jeremy J.
A1 Albers, Greg W.
A1 Dmytriw, Adam A.
A1 Faizy, Tobias D.
A1 Wintermark, Max
A1 Nael, Kambiz
A1 Rai, Ansaar T.
A1 Yedavalli, Vivek S.
YR 2025
UL http://www.ajnr.org/content/46/5/921.abstract
AB BACKGROUND AND PURPOSE: Pretreatment CTA-based Cortical Vein Opacification Score (COVES) has been shown to predict good functional outcomes at 90 days in patients with acute ischemic stroke secondary to large vessel occlusion (AIS-LVO). This is thought to be related to its ability to measure collateral status (CS). However, its association with the reference standard test, the DSA-based American Society of Interventional and Therapeutic Neuroradiology (ASITN) collateral score, has yet to be established. Therefore, this study assesses the relationship between COVES and ASITN CS.MATERIALS AND METHODS: In this prospectively collected, retrospectively reviewed analysis, patients with anterior circulation LVO from September 1, 2017, to October 1, 2023, were included. The COVES grading, which ranges from 0 to 6, was independently assessed by 2 board-certified neuroradiologists. The ASITN CS was independently assessed by a board-certified neuroradiologist and the performing neurointerventionalist. Any discrepancies were resolved through consensus review. Spearman rank correlation, univariable logistic regression, multivariable logistic regression, and receiver operating characteristic curve analysis were performed. A P value of ≤ .05 was considered significant.RESULTS: In total, 311 consecutive patients (median, IQR = 68 years [59–78 years]; 55.9% women) met our inclusion criteria. There was significant positive correlation between COVES and ASITN CS (ρ = 0.41, P < .001), and higher COVES was significantly and independently associated with good ASITN CS (unadjusted-OR = 1.74, P < .001) and adjusted-OR = 1.73, P < .001). Receiver operating characteristic curve analysis showed area under the curve of 0.71, P < .001).CONCLUSIONS: By demonstrating the independent association of COVES with the reference standard test for collateral status assessment, the ASITN CS, we further validate the role of COVES in estimating collateral status.AISacute ischemic strokeaORadjusted odds ratioASITNAmerican Society of Interventional and Therapeutic NeuroradiologyAUCarea under the curveCScollateral statusCOVESCortical Vein Opacification ScoreECASSEuropean-Australasian Acute Stroke StudyHIRhypoperfusion intensity ratioIVTintravenous thrombolysisLVOlarge vessel occlusionmCTAmultiphase CTAMTmechanical thrombectomyORodds ratioPHparenchymal hematomarCBFrelative cerebral blood flowROCreceiver operating characteristic curveTmaxtime to maximumuaORunadjusted odds ratioVOvenous outflow