Trial reportAnnals of neurology2011
Collaterals dramatically alter stroke risk in intracranial atherosclerosis.
Trial report in Annals of neurology, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02479243 (Arterial Spin Labeling MRI Assessment and Quantification of Collateral Circulation in Unilateral Middle Cerebral Artery Atherosclerotic Stenosis), which is not on this map. Cited by 145 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Arterial Spin Labeling MRI Assessment and Quantification of Collateral Circulation in Unilateral Middle Cerebral Artery Atherosclerotic Stenosis
Who cites it
145 citing papers in PubMed, 4 syntheses or guidelines pooled it, 307 citations in OpenAlex.
- Intracranial atherosclerotic plaque features on vessel wall imaging predict first ever and recurrence of stroke: a meta-analysis.European radiology · 2025Pooled it
- Clinical implications of haemodynamics in symptomatic intracranial atherosclerotic stenosis by computational fluid dynamics modelling: a systematic review.Stroke and vascular neurology · 2025Pooled it
- Multiple versus fewer antiplatelet agents for preventing early recurrence after ischaemic stroke or transient ischaemic attack.The Cochrane database of systematic reviews · 2020Pooled it
- Guidelines for evaluation and management of cerebral collateral circulation in ischaemic stroke 2017.Stroke and vascular neurology · 2018Guideline
- Encephaloduroarteriosynangiosis Averts Stroke in Atherosclerotic Patients With Border-Zone Infarct: Post Hoc Analysis From a Performance Criterion Phase II Trial.Neurosurgery · 2021Trial
- Short-term external counterpulsation augments cerebral blood flow and tissue oxygenation in chronic cerebrovascular occlusive disease.European journal of neurology · 2018Trial
- Trial
- Aggressive medical treatment with or without stenting in high-risk patients with intracranial artery stenosis (SAMMPRIS): the final results of a randomised trial.Lancet (London, England) · 2014 · on this mapTrial
- Trial
- Article
- Association of local collateral formation on TOF-MRA with plaque characteristics and ischemic stroke in intracranial atherosclerotic stenosis.BMC medical imaging · 2026Article
- Use of the neuroform atlas for stenting of intracranial atherosclerotic disease: Clinical and angiographic outcomes.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2026Article
- Parent Artery Disease-Related Stroke: What Is the Impact on Endovascular Treatment? A Narrative Review.Journal of clinical medicine · 2026Review
- Imaging Markers Predict the Short-Term and Long-Term Stroke Recurrence in Symptomatic Intracranial Atherosclerotic Disease.Cerebrovascular diseases extra · 2026Article
- Stroke risk prediction in symptomatic anterior circulation ICAD: Analysis of regional QMRA flow from the MYRIAD study.Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association · 2025Article
- Effect of RICAS (Remote Ischemic Preconditioning on Collaterals of Atherosclerosis Stroke): Rationale and Design.Journal of the American Heart Association · 2025Article
- CTA and DSA based computational fluid dynamics models for morphological and hemodynamic assessment of intracranial atherosclerotic stenosis.Frontiers in neurology · 2025Article
- Integrating hemodynamic analysis with traditional imaging in intracranial atherosclerotic stenosis: current status and future perspectives.Frontiers in neurology · 2025Review
- Arterial Lesion Location and Outcomes of Intracranial Atherosclerotic Disease.Stroke (Hoboken, N.J.) · 2024Article
- Encephaloduroarteriosynangiosis for Symptomatic Intracranial Atherosclerotic Arterial Steno-Occlusive Disease: Clinical and Radiological Outcomes.Journal of the American Heart Association · 2024Observational
85 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 4 institutions in 1 country.
Funding
Abstract
objectiveStroke risk due to intracranial atherosclerosis increases with degree of arterial stenosis. We evaluated the previously unexplored role of collaterals in modifying stroke risk in intracranial atherosclerosis and impact on subsequent stroke characteristics.
methodsCollateral flow was graded in blind fashion on 287 of 569 baseline angiograms (stenoses of 50-99% and adequate collateral views) in the Warfarin--Aspirin Symptomatic Intracranial Disease (WASID) trial. Statistical models predicted stroke in the symptomatic arterial territory based on collateral flow grade, percentage of stenosis, and previously demonstrated independent covariates.
resultsAcross all stenoses, extent of collaterals was a predictor for subsequent stroke in the symptomatic arterial territory (hazard ratio [HR] none vs good, 1.14; 95% confidence interval [CI], 0.39-3.30; poor vs good, 4.36; 95% CI, 1.46-13.07; p < 0.0001). For 70 to 99% stenoses, more extensive collaterals diminished risk of subsequent territorial stroke (HR none vs good, 4.60; 95% CI, 1.03-20.56; poor vs good, 5.90; 95% CI, 1.25-27.81; p = 0.0427). At milder degrees of stenoses (50-69%), presence of collaterals was associated with greater likelihood of subsequent stroke (HR none vs good, 0.18; 95% CI, 0.04-0.82; poor vs good, 1.78; 95% CI, 0.37-8.57; p < 0.0001). In multivariate analyses, extent of collaterals was an independent predictor for subsequent stroke in the symptomatic arterial territory (HR none vs good, 1.62; 95% CI, 0.52-5.11; poor vs good, 4.78; 95% CI, 1.55-14.7; p = 0.0019).
interpretationCollateral circulation is a potent determinant of stroke risk in intracranial atherosclerosis, demonstrating a protective role with severe stenoses and identifying more unstable milder stenoses.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.