Collateral score on ct angiography in patients with acute ischemic stroke: A retrospective study

  • Mathan Raj Radiology Department, Faculty of Medicine, Universiti Kebangsaan Malaysia.
  • Shahizon Azura Mukari Radiology Department, Faculty of Medicine, Universiti Kebangsaan Malaysia.
  • Wan Asyraf Wan Zaidi Department of Medicine, Faculty Medicine, Universiti Kebangsaan Malaysia Medical Centre.
  • Ahmad Sobri Muda Department of Radiology and Imaging, Faculty of Medicine, Universiti Putra Malaysia
Keywords: CTA brain, collateral score, clinical outcome, acute ischemic stroke, modified Rankin scale

Abstract

Objective: Clinically assessing the status of cerebral collaterals is thought to provide invaluable diagnostic and prognostic data in managing acute ischemic stroke (AIS) patients. In this study we present a report, based on commonly used collateral grading system, assessing the correlation between the collateral status seen on CT angiography and patients’ functional outcome at Day 90 in our institution.
Method: Patients presenting to the Emergency Department within 6 hours of onset of stroke from January 2010 until December 2014 were chosen for the study. CT angiography source images were retrospectively reviewed and given a “collateral score” (CS) by a radiologist who was blinded to the patient’s clinical information on presentation, as well as the clinical outcomes at 90 days. Patients’ mRS score at 90 days was obtained retrospectively and compared against the “collateral score”.
Results: 87 patients were enrolled into this study, of which 60 (69%) were male and 27 (31%) were female with a mean age of 60.3 years. In this study, 56 (64.4%) patients had a collateral score (CS) ≥ 2 and 31 (35.6%) patients had a CS < 2. Out of 56 patients who had a CS ≥ 2, 51 of them (91%) had good clinical outcome with a mRS ≤ 2. All the patients who had CS < 2 showed poor clinical outcome with a mRS > 2. The collateral score predicts accurately the clinical outcome with an area under the curve (ROC) of 0.75 (95% CI, 0.675-0.871, P=0.001). There is significant Spearman correlation between CS and the clinical outcome at Day 90, in patients with AIS during CTA analysis.
Conclusion: Our data supports the potential use of CS analysis in predicting clinical outcome of patients with AIS. Nevertheless, further study on a larger scale is strongly suggested to verify the reliability and reproducibility of CS assessment in CTA analysis prior to reperfusion in AIS patients

Published
2019-12-31
How to Cite
Mathan Raj, Shahizon Azura Mukari, Wan Asyraf Wan Zaidi, & Ahmad Sobri Muda. (2019). Collateral score on ct angiography in patients with acute ischemic stroke: A retrospective study. Cardiovascular, Neurovascular and Stroke, 1(1), 1-7. Retrieved from https://mycvns.com/index.php/cvns/article/view/4