Evidence map›Paper›PMID 31375893›Full record

ArticleClinical neuroradiology2020

Differential Benefit of Collaterals for Stroke Patients Treated with Thrombolysis or Supportive Care : A Propensity Score Matched Analysis.

Felix Schuler, Lukas T Rotkopf, Daniel Apel, Matthias P Fabritius, Steffen Tiedt, Frank A Wollenweber, Lars Kellert, Franziska Dorn, Thomas Liebig, Kolja M Thierfelder and 1 more

Abstract read
PubMed Publisher
In one paragraph

Article in Clinical neuroradiology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.2field-weighted citation impact, top 45% of its field
1 · What the graph read from it

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 4 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 2 institutions in 1 country.

Felix SchulerDepartment of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany. felix.schuler@gmx.de.ORCID http://orcid.org/0000-0002-1936-8011
Lukas T RotkopfDepartment of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany.
Daniel ApelDepartment of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany.
Matthias P FabritiusDepartment of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany.
Steffen TiedtInstitute for Stroke and Dementia Research, University Hospital, LMU Munich, Munich, Germany.
Frank A WollenweberInstitute for Stroke and Dementia Research, University Hospital, LMU Munich, Munich, Germany.
Lars KellertDepartment of Neurology, University Hospital, LMU Munich, Munich, Germany.
Franziska DornInstitute of Diagnostic and Interventional Neuroradiology, University Hospital, LMU Munich, Munich, Germany.
Thomas LiebigInstitute of Diagnostic and Interventional Neuroradiology, University Hospital, LMU Munich, Munich, Germany.
Kolja M ThierfelderInstitute for Diagnostic and Interventional Radiology, University Medical Center Rostock, Rostock, Germany.
Wolfgang G KunzDepartment of Radiology, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany.
LMU Klinikum · DEUniversity of Rostock · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeLeptomeningeal collaterals can slow down infarction growth; however, despite good collaterals in the DAWN and DEFUSE 3 trials, outcomes were devastating if reperfusion was not attempted. The aim of this study was to compare the influence of collaterals on morphological and functional outcome in patients with acute middle cerebral artery (MCA) stroke undergoing intravenous thrombolysis (IVT) vs. supportive care (non-IVT).

methodsOut of 1639 consecutive patients examined with multiparametric computed tomography (CT) for suspected ischemic stroke, all patients with confirmed MCA stroke who did not undergo endovascular thrombectomy were selected. Propensity score matching (PSM) was used to match IVT and non-IVT treated patients for potential confounders including age, sex, National Institutes of Health Stroke Scale (NIHSS) score on admission, Alberta Stroke Program Early CT Score (ASPECTS), and occlusion site. Regression analysis after PSM was performed to identify independent associations.

resultsAfter PSM, 90 IVT patients were matched with 90 non-IVT patients. In multivariable regression analysis, a high regional leptomeningeal collateral (rLMC) score was independently associated with lower final infarction volume (FIV) in the IVT group (b = -0.472, p < 0.001) but not in the non-IVT group (b = -0.116, p = 0.327). The trichotomized rLMC scores predicted functional outcome in IVT treated patients (adjusted odds ratio, aOR = 4.57, 95% confidence interval, CI, 1.03-20.32, p = 0.046) but showed no independent association with outcome in the non-IVT group (aOR = 0.69, 95% CI 0.07-6.80, p = 0.753).

conclusionGood collaterals favored smaller FIV and good functional outcome in IVT treated patients but not in non-IVT treated patients. Good collateral flow may have limited prognostic value if IVT is not administered to attempt reperfusion.

Indexed as

Collateral CirculationConservative TreatmentAgedAged, 80 and overFemaleHumansMaleMiddle AgedMiddle Cerebral ArteryPropensity ScoreStrokeThrombolytic TherapyTomography, X-Ray ComputedCBVCerebral circulationCT perfusionIschemiaIVT

Identifiers

PMID31375893
OpenAlexW2966426336

What OpenQuestion holds

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Registered trials

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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.