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    The velocity of collateral filling predicts recanalization in acute ischemic stroke after intravenous thrombolysis

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    Author
    Zhang, S; Zhang, X; Yan, S; Lai, Y; Han, Q; Sun, J; Zhang, M; Parsons, MW; Wang, S; Lou, M
    Date
    2016-06-14
    Source Title
    Scientific Reports
    Publisher
    NATURE PUBLISHING GROUP
    University of Melbourne Author/s
    Parsons, Mark
    Affiliation
    Medicine and Radiology
    Metadata
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    Document Type
    Journal Article
    Citations
    Zhang, S., Zhang, X., Yan, S., Lai, Y., Han, Q., Sun, J., Zhang, M., Parsons, M. W., Wang, S. & Lou, M. (2016). The velocity of collateral filling predicts recanalization in acute ischemic stroke after intravenous thrombolysis. SCIENTIFIC REPORTS, 6 (1), https://doi.org/10.1038/srep27880.
    Access Status
    Open Access
    URI
    http://hdl.handle.net/11343/256638
    DOI
    10.1038/srep27880
    Abstract
    The aim of this study was to evaluate the impact of pretreatment quality of collaterals, involving velocity and extent of collateral filling, on recanalization after intravenous thrombolysis (IVT). A retrospective analysis was performed of 66 patients with acute middle cerebral artery (MCA) M1 segment occlusion who underwent MR perfusion (MRP) imaging before IVT. The velocity of collateral filling was defined as arrival time delay (ATD) of contrast bolus to Sylvian fissure between the normal and the affected hemisphere. The extent of collateral filling was assessed according to the Alberta Stroke Program Early CT (ASPECT) score on temporally fused maximum intensity projections (tMIP). Arterial occlusive lesion (AOL) score was used to assess the degree of arterial recanalization. ATD (OR = 0.775, 95% CI = 0.626-0.960, p = 0.020), but not tMIP-ASPECT score (OR = 1.073, 95% CI = 0.820-1.405, p = 0.607), was independently associated with recanalization (AOL score of 2 and 3) at 24 hours after IVT. When recanalization was achieved, hemorrhagic transformation (HT) occurred more frequently in patients with slow collaterals (ATD ≥ 2.3 seconds) than those with rapid collaterals (ATD < 2.3 seconds) (88.9% vs 38.1%, p = 0.011). In conclusion, the velocity of collaterals related to recanalization, which may guide the decision-making of revascularization therapy in acute ischemic stroke.

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