Correlation Between CTA Collateral Circulation Scale And Prognosis Of Patients With Acute Ischemic Stroke After Reperfusion Therapy

Objective: We used different collateral circulation scales,including Alberta Stroke Program Early CT score(ASPECTs)、multi-phase computed tomography angiography score(mp CTAs)and regional leptomeningeal score(r LMCs),to analyze the correlation between collateral circulation and prognosis of patients with ischemic stroke after reperfusion therapy.We compared the validities and predictive values of three methods,which would provide an accurate measurement for collateral circulation before reperfusion treatment.Methods: 87 patients in our study were admitted to our hospital from October 2017 to November 2018,all of them were acute ischemic stroke with occlusion of inter carotid arteries or middle cerebral arteries,meanwhile they underwent multimodal CT imaging and were treated by reperfusion treatment.We collected the basic information and the collateral status which was evaluated by ASPECTs,mp CTAs and r LMCs.Prognosis of patients was assessed by modified Rankins scales 90 days after stroke.Spearman’s rank correlation and binary logistic regression were used to analyze correlation between three scales and prognosis,the predictive values of three methods was compared by the area under ROC curve.Result: Blood sugar,total cholesterol,LDL,baseline m Rs,NIHSS and the collateral status were important factors of outcomes of patients by univariable analyses,logistic regression showed main factors of bad outcomes including baseline m Rs(OR=4.786,95%CI=1.449~15.803,P=0.010),NIHSS(OR=1.245,95%CI=1.058~1.466,P=0.008)and r LMCs(OR= 0.523,95%CI =0.378 ~0.723,P<0.001).The Spearman’s rank correlation coefficients of r LMCs(rs=-0.648,P<0.01)is the highest.ROC curve suggested that the area under the curve of r LMCs was bigger than others,with the cut-off value was 10.5.Conclusion: collateral circulation is an independently protective factor of patients with acute ischemic stroke,the r LMCs has the highest validity and predictive value of reperfusion outcomes,the patient whose r LMCs was more than 11 has better outcome.