Evidence map›Paper›PMID 39023711›Full record

ArticleNeurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology2025

Multi-phase CT-Angiography outperforms angiographic careggi collateral score and predicts functional outcome in acute ischemic stroke.

Giorgio Busto, Ilaria Casetta, Andrea Morotti, Angelo Barra, Maria Giulia Maccaglia, Andrea Bianchi, Marco Moretti, Francesco Capasso, Maddalena Toffali, Francesco Arba and 3 more

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Article in Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

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0cells of the map it votes in
3citing papers in PubMed
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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

3 citing papers in PubMed.

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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

13 authors.

Giorgio BustoNeuroradiology Unit, Department of Radiology, Careggi University Hospital, Florence, Italy. giorgiobusto87@gmail.com.ORCID http://orcid.org/0000-0002-7007-6030
Ilaria CasettaIRCCS San Camillo Hospital, Venice, Italy.
Andrea MorottiNeurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
Angelo BarraDepartment of Technical Health Professions and Rehabilitation, Careggi University Hospital, Florence, Italy.
Maria Giulia MaccagliaNeuroradiology Unit, Department of Radiology, Careggi University Hospital, Florence, Italy.
Andrea BianchiNeuroradiology Unit, Department of Radiology, Careggi University Hospital, Florence, Italy.
Marco MorettiNeuroradiology Unit, Department of Radiology, Careggi University Hospital, Florence, Italy.
Francesco CapassoInterventional Neuroradiology Unit, University Hospital Careggi, Florence, Italy.
Maddalena ToffaliNeurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
Francesco ArbaStroke Unit, Careggi University Hospital, Florence, Italy.
Nicola LimbucciInterventional Neuroradiology Unit, University Hospital Careggi, Florence, Italy.
Alessandro PadovaniNeurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
Enrico FainardiNeuroradiology Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCollaterals are a strong determinant of clinical outcome in acute ischemic stroke (AIS) patients undergoing Endovascular Treatment (EVT). Careggi Collateral Score (CCS) is an angiographic score that demonstrated to be superior to the widely suggested ASITN/SIR score. Multi-phase CT-Angiography (mCTA) could be alternatively adopted for collateral assessment. We investigated whether mCTA had an equivalent predictive performance for functional outcome compared to CCS.

methodsConsecutive AIS patients undergoing EVT for large vessel occlusion within 24 h from onset were analyzed. Receiver operating characteristic curves and multivariable logistic regression were investigated to evaluate the predictive performance of mCTA collateral score (range 0-5) and CCS (range 0-4) for good functional outcome (three-months modified Rankin Scale 0-2).

resultsWe included 201 subjects (59.7% females, mean age 75), of whom 96 (47.7%) had good outcome at three-months. Both CCS (OR = 14.4, 95% CI = 6.3-33.8) and mCTA (OR = 23.8, 95% CI = 10.1-56.4) collateral scores were independent predictors of outcome. The AUC of CCS was 0.80 (95% CI 0.73-0.86) and the best cut-off was ≥ 3 (87% sensitivity, 71% specificity), while the AUC of mCTA collateral score was 0.84 (95% CI 0.78-0.90) with an optimal cut-off of ≥ 4 (85% sensitivity, 87% specificity). Patients with good mCTA collaterals experienced smaller (16.6 vs. 63.7 mL, p < 0.001) infarct lesion as compared to those with mCTA poor collaterals.

conclusionmCTA discriminative ability for three-months 0-2 mRS was found to be comparable to CCS. mCTA appears a valid, non-invasive imaging modality for evaluating collaterals of AIS patients potentially eligible for EVT.

Indexed as

Cerebral AngiographyCollateral CirculationComputed Tomography AngiographyIschemic StrokeAgedAged, 80 and overEndovascular ProceduresFemaleHumansMaleMiddle AgedPrognosisRetrospective StudiesSeverity of Illness IndexTreatment OutcomeAcute ischemic strokeCollateralsDigital Subtraction AngiographyLarge vessel occlusionMulti-phase CT-Angiography

Identifiers

PMID39023711

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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.