Evaluation Of Collateral Status In Predicting Outcome Of Mechanical Thrombectomy In Patients With Acute Ischemic Stroke

Background and purpose: Although intra-arterial therapy for acute ischemic stroke is associated with superior recanalization rates,improved clinical outcomes are inconsistently observed following successful recanalization.There is emerging concern that unfavorable arterial collateralization,though unproven,predetermines poor outcome.We hypothesized that poor leptomeningeal collateralization,assessed by preprocedural DSA,is associated with poor outcome in patients with acute ischemic stroke undergoing intra-arterial therapy.Material and methods: Retrospective analysis of 61 patients treated in authors' hospital during September 2015 to December 2017 from a prospective thrombectomy registry.Collateral status on DSA source images was categorized into good(3-4)and poor(0-2)with the ASITN/SIR scores.The association will be analysed between DSA collateral status and successful recanalization,favourable clinical outcome at 3-months(mRS 0-2)mortality and intracranial hemorrhages at follow-up.Results: The mean age of all the patients was 64.45±11.6 years and baseline median NIHSS score was 17(IQR 13-21).Patients with poor collateral status had a significant higher mortality compared with good collaterals during a mean follow-up period of 4.2(±3.2)months(13.63% and 0%,P<0.05).Analysis showed a significant association between good collateral status and the good functional outcome at 3-months.Conclusions: We found that good collateral status was associated with good outcome,after adjustment for recanalization success.The poor collateral status were independent predictors of death and higher rate of intracranial hemorrhages.