Vergleich unterschiedlicher Methoden zur Evaluation des Kollateralisierungsstatus als Prädiktor für das Ergebnis nach Thrombektomie

Comparison of different methods for evaluating the collateral status as a predictor of outcome after thrombectomy

by Carolin Peter
Doctoral thesis
Date of Examination:2021-08-17
Date of issue:2021-08-10
Advisor:Prof. Dr. Marios-Nikos Psychogios
Referee:Prof. Dr. Jan Liman
Referee:Prof. Dr. Ralf Dressel
Persistent Address: http://dx.doi.org/10.53846/goediss-8777

 

 

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Abstract

English

Collateral status is an important factor determining outcome in acute ischemic stroke. Hence, different collateral scoring systems have been introduced. We applied different scoring systems on single- and multi-phase computed tomography angiography and compared them to CT perfusion parameters to identify the best method for collateral evaluation in patients with acute ischemic stroke. A total of 102 patients with acute ischemic stroke due to large vessel occlusion in the anterior circulation who underwent multimodal CT imaging and who were treated endovascularly were included. Collateral status was assessed on spCTA and mpCTA using four different scoring systems and compared to CT perfusion parameters. Logistic regression was performed for predicting favorable outcome. All collateral scores correlated well with each other and with CT perfusion parameters. Comparison of collateral scores stratified by extent of perfusion deficit showed relevant differences between groups. A spCTA collateral score discriminated best between favorable and unfavorable outcome as determined using the modified Rankin Scale 3 months after stroke. Collateral status evaluated on spCTA may suffice for outcome prediction and decision making in acute ischemic stroke patients, potentially obviating further imaging modalities like mpCTA or CT perfusion.
Keywords: Acute stroke; Collateral circulation; Perfusion; Computed tomography angiography; Treatment outcome
 
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