Collateral Flow in Magnetic Resonance Angiography:Prognostic Value for Vertebrobasilar Stenosis With Stroke Recurrence
10.3988/jcn.2022.18.5.507
- Author:
Long YAN
1
;
Ying YU
;
Kaijiang KANG
;
Zhikai HOU
;
Min WAN
;
Weilun FU
;
Rongrong CUI
;
Yongjun WANG
;
Zhongrong MIAO
;
Xin LOU
;
Ning MA
Author Information
1. Departments of Interventional Neuroradiology and c Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Publication Type:ORIGINAL ARTICLE
- From:Journal of Clinical Neurology
2022;18(5):507-513
- CountryRepublic of Korea
- Language:English
-
Abstract:
Background:and Purpose Intracranial vertebrobasilar atherosclerotic stenosis (IVBAS) is a major cause of posterior circulation stroke. Some patients suffer from stroke recurrence despite receiving medical treatment. This study aimed to determine the prognostic value of a new score for the posterior communicating artery and the P1 segment of the posterior cerebral artery (PCoA-P1) for predicting stroke recurrence in IVBAS.
Methods:We retrospectively enrolled patients with severe IVBAS (70%–99%). According to the number of stroke recurrences, patients were divided into no-recurrence, single-recurrence, and multiple-recurrences groups. We developed a new 5-point grading scale, with the PCoA-P1 score ranging from 0 to 4 based on magnetic resonance angiography, in which primary collaterals were dichotomized into good (2–4 points) and poor (0 or 1 point). Stroke recurrences after the index stroke were recorded. Patients who did not experience stroke recurrence were compared with those who experienced single or multiple stroke recurrences.
Results:From January 2012 to December 2019, 176 patients were enrolled, of which 116 (65.9%) had no stroke recurrence, 35 (19.9%) had a single stroke recurrence, and 25 (14.2%) had multiple stroke recurrences. Patients with single stroke recurrence (odds ratio [OR]= 4.134, 95% confidence interval [CI]=1.822–9.380, p=0.001) and multiple stroke recurrences (OR=6.894, 95% CI=2.489–19.092, p<0.001) were more likely to have poor primary collaterals than those with no stroke recurrence.
Conclusions:The new PCoA-P1 score appears to provide improve predictions of stroke recurrence in patients with IVBAS.
