Trial reportStroke2015
Differential Effect of Baseline Computed Tomographic Angiography Collaterals on Clinical Outcome in Patients Enrolled in the Interventional Management of Stroke III Trial.
Open access · bronzeAbstract readRandomized Controlled Trial
In one paragraph
Trial report in Stroke, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 64 papers, 1 of them a synthesis that pooled it.
0numbers the graph read from it
0cells of the map it votes in
64citing papers in PubMed, 1 pooled it
10.9field-weighted citation impact, top 1% of its field
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
64 citing papers in PubMed, 1 synthesis or guideline pooled it, 145 citations in OpenAlex.
- Guidelines for evaluation and management of cerebral collateral circulation in ischaemic stroke 2017.Stroke and vascular neurology · 2018Guideline
- Time Since Stroke Onset, Quantitative Collateral Score, and Functional Outcome After Endovascular Treatment for Acute Ischemic Stroke.Neurology · 2022Trial
- Time for a Time Window Extension: Insights from Late Presenters in the ESCAPE Trial.AJNR. American journal of neuroradiology · 2018Trial
- Correlation between Clinical Outcomes and Baseline CT and CT Angiographic Findings in the SWIFT PRIME Trial.AJNR. American journal of neuroradiology · 2017Trial
- Collateral status and tissue outcome after intra-arterial therapy for patients with acute ischemic stroke.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2017Trial
- Changes in collateral status during transfer for thrombectomy are predictive of functional outcome in large vessel occlusion stroke.GeroScience · 2026Article
- Factors Associated with Leptomeningeal Collaterals and Their Impact on Functional Outcomes in Anterior Circulation Acute Ischemic Stroke.Annals of Indian Academy of Neurology · 2026Article
- Time is brain: an expanded concept, not only for ischemic stroke A viewpoint of the Italian Association for Emergency Neurology (ANEU).Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026Review
- Prediction of recurrence in patients with non-acute atherosclerotic middle cerebral artery occlusion: A longitudinal study using computed tomography perfusion and magnetic resonance imaging.The Journal of international medical research · 2026Article
- The value of venous outflow assessment based on multiphase CTA in predicting the prognosis of endovascular therapy for acute ischemic stroke patients.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026Article
- Automated assessment of collateral circulation and infarct core: predictors of functional outcomes in acute ischemic stroke following endovascular thrombectomy.Neuroradiology · 2025Article
- MRI-based Quantitative Collateral Assessment in Acute Stroke : A Comparison with Single-phase CTA in Drip-and-ship Patients with Serial Imaging.Clinical neuroradiology · 2025Article
- Predictors of futile recanalization after intravenous thrombolysis in stroke patients transferred for endovascular treatment.Journal of thrombosis and thrombolysis · 2025Article
- The CT collateral map: collateral perfusion estimation and baseline lesion assessment after acute anterior circulation ischemic stroke.La Radiologia medica · 2025Article
- Sanctuary sites in cortical stroke.Frontiers in neurology · 2025Article
- Safety and Efficacy of Thrombectomy in Vietnamese Stroke Patients Selected through Perfusion Imaging with an Onset Time between 6 and 24 Hours.Cerebrovascular diseases extra · 2025Observational
- Optimizing Radiation Dose and Image Quality in Stroke CT Protocols: Proposed Diagnostic Reference Levels for Multiphase CT Angiography and Perfusion Imaging.Diagnostics (Basel, Switzerland) · 2024Article
- Prognostic Value of Venous Outflow Profiles on Multiphase CT Angiography for the Patients with Acute Ischemic Stroke After Endovascular Thrombectomy.Translational stroke research · 2024Article
- The impacts of venous outflow profiles on outcomes among large vessel occlusion patients receiving endovascular treatment in the late window.European radiology · 2024Article
- Involvement of Subinsular Territory Stroke as Predictor of Outcome after Successful Endovascular Recanalization of Left Middle Cerebral Artery Occlusion.Brain sciences · 2024Article
4 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
13 authors at 5 institutions in 2 countries.
Bijoy K MenonFrom the Calgary Stroke Program and the Department of Clinical Neurosciences (B.K.M., E.Q., V.N., M.G., M.D.H., A.M.D.), Department of Radiology (B.K.M., M.G., M.D.H., A.M.D.), University of Calgary, Calgary, Canada; Department of Public Health Sciences, Medical University of South Carolina, Charleston (L.D.F., S.D.Y.); Department of Neurosciences, University of California, Los Angeles (D.L.); Department of Neurosciences, University of Pittsburgh Medical Center, PA (T.G.J.); Department of Community Health Sciences, University of Calgary, Calgary, Canada (M.D.H.); Department of Radiology (T.A.T.), Department of Neurology (J.P.B.), University of Cincinnati, OH; and Hotchkiss Brain Institute, Calgary, Canada (B.K.M., M.G., M.D.H., A.M.D.).
Emmad QaziFrom the Calgary Stroke Program and the Department of Clinical Neurosciences (B.K.M., E.Q., V.N., M.G., M.D.H., A.M.D.), Department of Radiology (B.K.M., M.G., M.D.H., A.M.D.), University of Calgary, Calgary, Canada; Department of Public Health Sciences, Medical University of South Carolina, Charleston (L.D.F., S.D.Y.); Department of Neurosciences, University of California, Los Angeles (D.L.); Department of Neurosciences, University of Pittsburgh Medical Center, PA (T.G.J.); Department of Community Health Sciences, University of Calgary, Calgary, Canada (M.D.H.); Department of Radiology (T.A.T.), Department of Neurology (J.P.B.), University of Cincinnati, OH; and Hotchkiss Brain Institute, Calgary, Canada (B.K.M., M.G., M.D.H., A.M.D.).
Vivek NambiarFrom the Calgary Stroke Program and the Department of Clinical Neurosciences (B.K.M., E.Q., V.N., M.G., M.D.H., A.M.D.), Department of Radiology (B.K.M., M.G., M.D.H., A.M.D.), University of Calgary, Calgary, Canada; Department of Public Health Sciences, Medical University of South Carolina, Charleston (L.D.F., S.D.Y.); Department of Neurosciences, University of California, Los Angeles (D.L.); Department of Neurosciences, University of Pittsburgh Medical Center, PA (T.G.J.); Department of Community Health Sciences, University of Calgary, Calgary, Canada (M.D.H.); Department of Radiology (T.A.T.), Department of Neurology (J.P.B.), University of Cincinnati, OH; and Hotchkiss Brain Institute, Calgary, Canada (B.K.M., M.G., M.D.H., A.M.D.).
Lydia D FosterFrom the Calgary Stroke Program and the Department of Clinical Neurosciences (B.K.M., E.Q., V.N., M.G., M.D.H., A.M.D.), Department of Radiology (B.K.M., M.G., M.D.H., A.M.D.), University of Calgary, Calgary, Canada; Department of Public Health Sciences, Medical University of South Carolina, Charleston (L.D.F., S.D.Y.); Department of Neurosciences, University of California, Los Angeles (D.L.); Department of Neurosciences, University of Pittsburgh Medical Center, PA (T.G.J.); Department of Community Health Sciences, University of Calgary, Calgary, Canada (M.D.H.); Department of Radiology (T.A.T.), Department of Neurology (J.P.B.), University of Cincinnati, OH; and Hotchkiss Brain Institute, Calgary, Canada (B.K.M., M.G., M.D.H., A.M.D.).
Sharon D YeattsFrom the Calgary Stroke Program and the Department of Clinical Neurosciences (B.K.M., E.Q., V.N., M.G., M.D.H., A.M.D.), Department of Radiology (B.K.M., M.G., M.D.H., A.M.D.), University of Calgary, Calgary, Canada; Department of Public Health Sciences, Medical University of South Carolina, Charleston (L.D.F., S.D.Y.); Department of Neurosciences, University of California, Los Angeles (D.L.); Department of Neurosciences, University of Pittsburgh Medical Center, PA (T.G.J.); Department of Community Health Sciences, University of Calgary, Calgary, Canada (M.D.H.); Department of Radiology (T.A.T.), Department of Neurology (J.P.B.), University of Cincinnati, OH; and Hotchkiss Brain Institute, Calgary, Canada (B.K.M., M.G., M.D.H., A.M.D.).
David LiebeskindFrom the Calgary Stroke Program and the Department of Clinical Neurosciences (B.K.M., E.Q., V.N., M.G., M.D.H., A.M.D.), Department of Radiology (B.K.M., M.G., M.D.H., A.M.D.), University of Calgary, Calgary, Canada; Department of Public Health Sciences, Medical University of South Carolina, Charleston (L.D.F., S.D.Y.); Department of Neurosciences, University of California, Los Angeles (D.L.); Department of Neurosciences, University of Pittsburgh Medical Center, PA (T.G.J.); Department of Community Health Sciences, University of Calgary, Calgary, Canada (M.D.H.); Department of Radiology (T.A.T.), Department of Neurology (J.P.B.), University of Cincinnati, OH; and Hotchkiss Brain Institute, Calgary, Canada (B.K.M., M.G., M.D.H., A.M.D.).
Tudor G JovinFrom the Calgary Stroke Program and the Department of Clinical Neurosciences (B.K.M., E.Q., V.N., M.G., M.D.H., A.M.D.), Department of Radiology (B.K.M., M.G., M.D.H., A.M.D.), University of Calgary, Calgary, Canada; Department of Public Health Sciences, Medical University of South Carolina, Charleston (L.D.F., S.D.Y.); Department of Neurosciences, University of California, Los Angeles (D.L.); Department of Neurosciences, University of Pittsburgh Medical Center, PA (T.G.J.); Department of Community Health Sciences, University of Calgary, Calgary, Canada (M.D.H.); Department of Radiology (T.A.T.), Department of Neurology (J.P.B.), University of Cincinnati, OH; and Hotchkiss Brain Institute, Calgary, Canada (B.K.M., M.G., M.D.H., A.M.D.).
Mayank GoyalFrom the Calgary Stroke Program and the Department of Clinical Neurosciences (B.K.M., E.Q., V.N., M.G., M.D.H., A.M.D.), Department of Radiology (B.K.M., M.G., M.D.H., A.M.D.), University of Calgary, Calgary, Canada; Department of Public Health Sciences, Medical University of South Carolina, Charleston (L.D.F., S.D.Y.); Department of Neurosciences, University of California, Los Angeles (D.L.); Department of Neurosciences, University of Pittsburgh Medical Center, PA (T.G.J.); Department of Community Health Sciences, University of Calgary, Calgary, Canada (M.D.H.); Department of Radiology (T.A.T.), Department of Neurology (J.P.B.), University of Cincinnati, OH; and Hotchkiss Brain Institute, Calgary, Canada (B.K.M., M.G., M.D.H., A.M.D.).
Michael D HillFrom the Calgary Stroke Program and the Department of Clinical Neurosciences (B.K.M., E.Q., V.N., M.G., M.D.H., A.M.D.), Department of Radiology (B.K.M., M.G., M.D.H., A.M.D.), University of Calgary, Calgary, Canada; Department of Public Health Sciences, Medical University of South Carolina, Charleston (L.D.F., S.D.Y.); Department of Neurosciences, University of California, Los Angeles (D.L.); Department of Neurosciences, University of Pittsburgh Medical Center, PA (T.G.J.); Department of Community Health Sciences, University of Calgary, Calgary, Canada (M.D.H.); Department of Radiology (T.A.T.), Department of Neurology (J.P.B.), University of Cincinnati, OH; and Hotchkiss Brain Institute, Calgary, Canada (B.K.M., M.G., M.D.H., A.M.D.).
Thomas A TomsickFrom the Calgary Stroke Program and the Department of Clinical Neurosciences (B.K.M., E.Q., V.N., M.G., M.D.H., A.M.D.), Department of Radiology (B.K.M., M.G., M.D.H., A.M.D.), University of Calgary, Calgary, Canada; Department of Public Health Sciences, Medical University of South Carolina, Charleston (L.D.F., S.D.Y.); Department of Neurosciences, University of California, Los Angeles (D.L.); Department of Neurosciences, University of Pittsburgh Medical Center, PA (T.G.J.); Department of Community Health Sciences, University of Calgary, Calgary, Canada (M.D.H.); Department of Radiology (T.A.T.), Department of Neurology (J.P.B.), University of Cincinnati, OH; and Hotchkiss Brain Institute, Calgary, Canada (B.K.M., M.G., M.D.H., A.M.D.).
Joseph P BroderickFrom the Calgary Stroke Program and the Department of Clinical Neurosciences (B.K.M., E.Q., V.N., M.G., M.D.H., A.M.D.), Department of Radiology (B.K.M., M.G., M.D.H., A.M.D.), University of Calgary, Calgary, Canada; Department of Public Health Sciences, Medical University of South Carolina, Charleston (L.D.F., S.D.Y.); Department of Neurosciences, University of California, Los Angeles (D.L.); Department of Neurosciences, University of Pittsburgh Medical Center, PA (T.G.J.); Department of Community Health Sciences, University of Calgary, Calgary, Canada (M.D.H.); Department of Radiology (T.A.T.), Department of Neurology (J.P.B.), University of Cincinnati, OH; and Hotchkiss Brain Institute, Calgary, Canada (B.K.M., M.G., M.D.H., A.M.D.).
Andrew M DemchukFrom the Calgary Stroke Program and the Department of Clinical Neurosciences (B.K.M., E.Q., V.N., M.G., M.D.H., A.M.D.), Department of Radiology (B.K.M., M.G., M.D.H., A.M.D.), University of Calgary, Calgary, Canada; Department of Public Health Sciences, Medical University of South Carolina, Charleston (L.D.F., S.D.Y.); Department of Neurosciences, University of California, Los Angeles (D.L.); Department of Neurosciences, University of Pittsburgh Medical Center, PA (T.G.J.); Department of Community Health Sciences, University of Calgary, Calgary, Canada (M.D.H.); Department of Radiology (T.A.T.), Department of Neurology (J.P.B.), University of Cincinnati, OH; and Hotchkiss Brain Institute, Calgary, Canada (B.K.M., M.G., M.D.H., A.M.D.). ademchuk@ucalgary.ca.
Interventional Management of Stroke III Investigators
University of Calgary · CAUniversity of California, Los Angeles · USUniversity of Pittsburgh Medical Center · USUniversity of Cincinnati · USMedical University of South Carolina · US
Funding
Interventional Management of Stroke Study (IMS III)U01NS052220 · NINDS · UNIVERSITY OF CINCINNATI · PI BRODERICK, JOSEPH PAUL · 2005 to 2012
$21.9MThe ALIAS StudyU01NS054630 · NINDS · MEDICAL UNIVERSITY OF SOUTH CAROLINA · PI PALESCH, YUKO Y · 2005 to 2010
$6.9MInterventional Management of Stroke Phase III Trial - SDCCU01NS077304 · NINDS · MEDICAL UNIVERSITY OF SOUTH CAROLINA · PI PALESCH, YUKO Y · 2011 to 2013
$1.4MModeling of Collateral Perfusion in the Ischemic BrainK24NS072272 · NINDS · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI LIEBESKIND, DAVID SIGMUND · 2011 to 2015
$939kCanadian Institutes of Health ResearchNINDS NIH HHS K24 NS072272NINDS NIH HHS K24NS072272NINDS NIH HHS U01 NS052220NINDS NIH HHS U01 NS054630NINDS NIH HHS U01 NS077304
Abstract
background and purposeIn the Interventional Management of Stroke (IMS) III trial, we sought to demonstrate evidence of a differential treatment effect of endovascular treatment of acute ischemic stroke compared with intravenous tissue-type plasminogen activator, according to baseline collateral status measured using computed tomographic angiography.
methodsOf 656 patients enrolled in Interventional Management of Stroke III trial, 306 had baseline computed tomographic angiography. Of these, 185 patients had M1 middle cerebral artery ± intracranial internal carotid artery occlusion, where baseline collateral status could be measured. Collateral status was assessed by consensus using 3 different ordinal scales and categorized as good, intermediate, and poor. Multivariable modeling was used to assess the effect of collateral status and treatment type on clinical outcome by modified Rankin Scale (mRS 0-2, mRS 0-1, and the ordinal mRS).
resultsOf 185 patients, 126 randomized to endovascular therapy (87.6% recanalized, 41.3% 90-day mRS 0-2) and 59 to intravenous tissue-type plasminogen activator only (60.5% recanalized, 30.5% 90-day mRS 0-2). In multivariable modeling, collateral status was a significant predictor of all clinical outcomes (P<0.05). Maximal benefit with endovascular treatment across all clinical outcomes was seen in patients with intermediate collaterals, some benefit in patients with good collaterals, and none in patients with poor collaterals, although small sample size limited the power of the analysis to show a statistically significant interaction between collateral status and treatment type (P>0.05).
conclusionUsing data from a large randomized controlled trial (IMS III), we show that baseline computed tomographic angiography collaterals are a robust determinant of final clinical outcome and could be used to select patients for endovascular therapy. CLINICAL
trial registrationURL: http://www.clinicaltrials.gov/ct2/show/. Unique identifier: 0020NCT00359424.
Indexed as
Collateral CirculationAdultAgedAged, 80 and overBrain IschemiaCerebral AngiographyEndovascular ProceduresFemaleFibrinolytic AgentsHumansImage Processing, Computer-AssistedMaleMiddle AgedStrokeThrombolytic TherapyTissue Plasminogen ActivatorFibrinolytic AgentsTissue Plasminogen Activatorcollateral circulationendovascular techniquesstroke
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