Abstract Details

Title Cerebral Collateral Flow State in Acute Ischemic Stroke Correlates with Clinical Functional Outcome

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) Cerebrovascular Disease and Interventional Neurology Posters (7:00 AM-5:00 PM)

Poster/Presentation
Number 206

Objective To evaluate association between collateral flow state measured from CT perfusion (CTP) in acute ischemic stroke (AIS) patients and functional clinical outcome at discharge .

Background In AIS patients, cerebral perfusion parameters specifically relative cerebral blood volume (rCBV) and hypoperfusion index ratio (HIR), have been shown to predict infarct progression and collateral flow respectively. In addition, burden and severity of stroke has been accurately predicted by Core Volume (CV) and Mismatch Ratio (MR). Higher rCBV and low HIR are associated with good collateral flow in AIS patients.

Design/Methods Retrospectively, Get With the Guideline® database was linked with cerebral perfusion database in a Comprehensive Stroke Center (January 2018 - July 2020). Additional data collection included patient demographics, NIH stroke scale on admission (NIHSS), Modified Rankin Scale (mRS) at discharge. The RAPID CTP software provided CBV values from Tmax > 6 s area. HIR = volumes with Tmax > 10 s / Tmax > 6 s. The mismatch ratio = volumes with hypoperfusion (Tmax > 6 s )/ ischemic core (cerebral blood flow<30%). Correlation was tested using Spearman’s rho coefficient (ρ).

Results From a consecutive 4918 patients, collateral flow state was assessed using RAPID CTP data including HIR, CV and MR in 1445 patients with mean age ± standard deviation: 67.9 ± 14.5 years; NIHSS on admission: Median 7 with Interquartile Range of 7-14; racial distribution of sample: White 49%, African-American 48%, Asian 1%, Others 2%; gender distribution: 50% Males and 50 % Females; mRS score and percentage distribution: 0 (7.3%), 1 (6.1%), 2 (4.7%), 3 (12.3%), 4 (38.5%), 5 (23.9%) and 6 (7.1%); Correlation between RAPID CV and mRS: ρ=0.249 (p<0.001); HIR and mRS: ρ=0.212 (p<0.001); MR and mRS: ρ=-0.255 (p<0.001) were significant.

Conclusions Collateral flow state measured by RAPID CTP in AIS patients correlated significantly with better clinical functional outcomes as measured by mRS on discharge.

Authors/Disclosures
Smit Shah, MD PRESENTER	Dr. Shah has nothing to disclose.
Kathryn B. Thornton, MD (Marshall Neurology)	Dr. Thornton has nothing to disclose.
	No disclosure on file
Nishanth Kodumuri, MD (Palmetto Health Richland)	Dr. Kodumuri has nothing to disclose.
Ravish A. Kothari, MD	Dr. Kothari has nothing to disclose.
Forrest J. Lowe, MD	Dr. Lowe has nothing to disclose.
Yedatore S. Venkatesh, MD, F�鶹��ýӳ�� (University of SC School of Medicine)	Dr. Venkatesh has nothing to disclose.
Souvik Sen, MD, MS (USC Neurology)	Dr. Sen has nothing to disclose.

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