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  The association between recanalization, collateral flow, and reperfusion in acute stroke patients: A dynamic susceptibility contrast MRI study

Villringer, K., Zimny, S., Galinovic, I., Nolte, C. H., Fiebach, J. B., & Khalil, A. (2019). The association between recanalization, collateral flow, and reperfusion in acute stroke patients: A dynamic susceptibility contrast MRI study. Frontiers in Neurology, 10: 1147. doi:10.3389/fneur.2019.01147.

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Item Permalink: http://hdl.handle.net/21.11116/0000-0005-621D-D Version Permalink: http://hdl.handle.net/21.11116/0000-0005-7AD0-7
Genre: Journal Article

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 Creators:
Villringer, Kersten1, Author
Zimny, Sascha1, 2, Author
Galinovic, Ivana1, Author
Nolte, Christian H.1, 3, Author
Fiebach, Jochen B.1, Author
Khalil, Ahmed1, 4, 5, 6, Author              
Affiliations:
1Center for Stroke Research, Charité University Medicine Berlin, Germany, ou_persistent22              
2Department of Neurology, Diakonissenkrankenhaus, Flensburg, Germany, ou_persistent22              
3Department of Neurology, Charité University Medicine Berlin, Germany, ou_persistent22              
4Department Neurology, MPI for Human Cognitive and Brain Sciences, Max Planck Society, ou_634549              
5MindBrainBody Institute, Berlin School of Mind and Brain, Humboldt University Berlin, Germany, ou_persistent22              
6Berlin Institute of Health (BIH), Germany, ou_persistent22              

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Free keywords: Reperfusion; Collateral flow; Recanalization; Stroke; MRI
 Abstract: Background: Collateral circulation in ischemic stroke patients plays an important role in infarct evolution und assessing patients' eligibility for endovascular treatment. By means of dynamic susceptibility contrast MRI, we aimed to investigate the effects of reperfusion, recanalization, and collateral flow on clinical and imaging outcomes after stroke. Methods: Retrospective analysis of 184 patients enrolled into the prospective observational 1000Plus study (clinicaltrials.org NCT00715533). Inclusion criteria were vessel occlusion on baseline MR-angiography, imaging within 24 h after stroke onset and follow-up perfusion imaging. Baseline Higashida score using subtracted dynamic MR perfusion source images was used to quantify collateral flow. The influence of these variables, and their interaction with vessel recanalization, on clinical and imaging outcomes was assessed using robust linear regression. Results: Ninety-eight patients (53.3%) showed vessel recanalization. Higashida score (p = 0.002), and recanalization (p = 0.0004) were independently associated with reperfusion. However, we found no evidence that the association between Higashida score and reperfusion relied on recanalization status (p = 0.2). NIHSS on admission (p < 0.0001) and recanalization (p = 0.001) were independently associated with long-term outcome at 3 months, however, Higashida score (p = 0.228) was not. Conclusion: Higashida score and recanalization were independently associated with reperfusion, but the association between recanalization and reperfusion was similar regardless of collateral flow quality. Recanalization was associated with long-term outcome. DSC-based measures of collateral flow were not associated with long-term outcome, possibly due to the complex dynamic nature of collateral recruitment, timing of imaging and the employed post-processing.

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Language(s): eng - English
 Dates: 2019-08-072019-10-142019-10-25
 Publication Status: Published online
 Pages: -
 Publishing info: -
 Table of Contents: -
 Rev. Type: Peer
 Identifiers: DOI: 10.3389/fneur.2019.01147
Other: eCollection 2019
PMID: 31708866
PMC: PMC6823193
 Degree: -

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Project name : -
Grant ID : 01EO0801
Funding program : -
Funding organization : German Federal Ministry of Education and Research (BMBF)
Project name : -
Grant ID : -
Funding program : BIH-Charité Junior Clinician Scientist Program
Funding organization : Charite - University Medicine Berlin and the Berlin Institute

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Title: Frontiers in Neurology
Source Genre: Journal
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Publ. Info: Lausanne, Switzerland : Frontiers Research Foundation
Pages: - Volume / Issue: 10 Sequence Number: 1147 Start / End Page: - Identifier: ISSN: 1664-2295
CoNE: https://pure.mpg.de/cone/journals/resource/1664-2295