ArticleNeuroradiology2019
Collaterals are a major determinant of the core but not the penumbra volume in acute ischemic stroke.
Article in Neuroradiology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers.
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Who cites it
25 citing papers in PubMed.
- Factors Associated with Leptomeningeal Collaterals and Their Impact on Functional Outcomes in Anterior Circulation Acute Ischemic Stroke.Annals of Indian Academy of Neurology · 2026Article
- Comparison of AI-assisted quantitative collateral score and visual collateral score in stroke thrombectomy triage.Neuroradiology · 2026Article
- Combined assessment of ASPECTS and collateral status predict outcomes after endovascular therapy in patients with large ischemic stroke.Frontiers in neurology · 2026Observational
- Poor venous outflow is associated with hyperintense acute reperfusion marker on follow-up MRI in patients with acute ischemic stroke with a large vessel occlusion.Journal of neurointerventional surgery · 2025Article
- Collateral Status Evaluation Using CT Angiography and Perfusion Source Images in Acute Stroke Patients.Brain sciences · 2025Article
- Thrombus Imaging Features for Anterior Circulation Stroke: Their Impact on CTP Parameters and Natural Evolution of Infarct Progression.Journal of personalized medicine · 2025Article
- Relationship Between Collateral Status, Infarct Growth and Outcome in Patients with Middle Cerebral Artery Occlusion by CT Angiography and CT Perfusion Imaging.Noro psikiyatri arsivi · 2025Article
- Cerebral collaterals are associated with pre-treatment brain-blood barrier permeability in acute ischemic stroke patients.European radiology · 2024Observational
- Communicating Arteries and Leptomeningeal Collaterals: A Synergistic but Independent Effect on Patient Outcomes after Stroke.Neurology international · 2024Article
- Global hyperperfusion after successful endovascular thrombectomy is linked to worse outcome in acute ischemic stroke.Scientific reports · 2024Article
- Factors Contributing to Rapid Early Infarct Expansion in Acute Ischemic Stroke Patients With Large Vessel Occlusion.Cureus · 2024Article
- The collateral map: prediction of lesion growth and penumbra after acute anterior circulation ischemic stroke.European radiology · 2024Article
- Association of renal biomarkers with fast progressor phenotype and related outcomes in anterior circulation large vessel occlusion stroke.Frontiers in neurology · 2024Article
- Factors Associated With Fast Early Infarct Growth in Patients With Acute Ischemic Stroke With a Large Vessel Occlusion.Neurology · 2023Article
- The Presence of Communicating Arteries in the Circle of Willis Is Associated with Higher Rate of Functional Recovery after Anterior Circulation Ischemic Stroke.Biomedicines · 2023Article
- Pivotal role of multiphase computed tomography angiography for collateral assessment in patients with acute ischemic stroke.La Radiologia medica · 2023Review
- Predicting Penumbra Salvage and Infarct Growth in Acute Ischemic Stroke: A Multifactor Survival Game.Journal of clinical medicine · 2023Article
- Leptomeningeal Collateral Status by Signal Variance in Perfusion Magnetic Resonance Imaging: Association With Initial Stroke Severity and Early Functional Outcome After Thrombectomy.Stroke (Hoboken, N.J.) · 2023Article
- Collateral Circulation in Ischemic Stroke: An Updated Review.Journal of stroke · 2023Review
- Review of Current Large Core Volume Stroke Thrombectomy Clinical Trials: Controversies and Progress.Stroke (Hoboken, N.J.) · 2022Review
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeDeterminants of early loss of ischemic tissue (core) or its prolonged survival (penumbra) in acute ischemic stroke (AIS) are poorly understood. We aimed to identify radiological associations of core and penumbra volumes on CT perfusion (CTP) in a large cohort of AIS.
methodsIn the ASTRAL registry (2003-2016), we identified consecutive AIS patients with proximal middle cerebral artery (MCA) occlusion. We calculated core and penumbra volumes using established thresholds and the mismatch ratio (MR). We graded collaterals into three categories on CT-angiography. We used clot burden score (CBS) to quantify the clot length. We related CTP volumes to radiological variables in multivariate regression analyses, adjusted for time from stroke onset to first imaging.
resultsThe median age of the 415 included patients was 69 years (IQR = 21) and 49% were female. Median admission NIHSS was 16 (11) and median delay to imaging 2.2 h (1.9). Lower core volumes were associated with higher ASPECTS (hazard ratio = 1.08), absence of hyperdense MCA sign (HR = 0.70), higher CBS (i.e., smaller clot, HR = 1.10), and better collaterals (HR = 1.95). Higher penumbra volumes were related to lower CBS (i.e., longer clot, HR = 1.08) and proximal intracranial occlusion (HR = 1.47), but not to collaterals. Higher MR was found in absence of hyperdense MCA sign (HR = 1.28), absence of distal intracranial occlusion (HR = 1.39), and with better collaterals (HR = 0.52).
conclusionsIn AIS, better collaterals were associated with lower core volumes, but not with higher penumbra volumes. This suggests a major role of collaterals in early tissue loss and their limited significance as marker of salvageable tissue.
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