ArticleTranslational stroke research2025
Favorable Cerebral Collateral Cascades Improve Futile Recanalization by Reducing Ischemic Core Volume in Acute Ischemic Stroke Patients Undergoing Endovascular Treatment.
Article in Translational stroke research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- Beyond plaque morphology: a multimodal imaging model combining structural vulnerability and functional reserve predicts stroke recurrence in symptomatic intracranial atherosclerosis.Quantitative imaging in medicine and surgery · 2026Article
- Deep medullary vein drainage and unfavorable outcomes in stroke patients after endovascular therapy: a retrospective study.BMC neurology · 2026Observational
- Association of cerebral collateral cascade with early neurological deterioration after endovascular thrombectomy in patients with acute ischemic stroke.Quantitative imaging in medicine and surgery · 2026Article
- Association of Post-procedural Glucose with Clinical Outcomes After Endovascular Therapy for Large Vessel Occlusion.Neurology and therapy · 2026Article
- Progress on using CTA-based vessel distance index to predict futile recanalization: a retrospective observational study.BMC neurology · 2026Observational
- Risk score for futile recanalization: integrating cerebral circulation time and collateral cascade.Frontiers in aging neuroscience · 2026Article
- Venous outflow time profiles: promising imaging biomarkers for futile recanalization in acute ischemic stroke due to large vessel occlusion.Frontiers in neurology · 2025Article
- Prediction of collateral circulation grading and functional outcomes in acute ischemic stroke using FLAIR vascular hyperintensity combined with multimodal CT parameters.Frontiers in neurologyArticle
- Impact of collateral status on functional outcomes in acute cardioembolic stroke after successful endovascular thrombectomy.Frontiers in neurologyArticle
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Authors and funding
12 authors.
Funding
Abstract
Although endovascular treatment (EVT) was the first-line therapeutic strategy for acute ischemic stroke (AIS), half of the patients could not achieve functional independence. Previous studies suggested arterial collateral was an important predictor of this phenomenon. However, cerebral collateral circulation was regulated by arteries, venous, and microcirculation, and its role remained unclear. Therefore, based on the integrated cerebral collateral cascade (CCC) system, this study aimed to explore the relationship and potential mechanisms between CCC and futile recanalization. This was a multicenter retrospective study for AIS patients receiving EVT. The CCC model was used to comprehensively assess the collateral circulation, which consisted of arterial collaterals, venous outflow, and tissue-level collaterals. Imaging outcomes included ischemic core, hypoperfusion volume, and penumbra volume. The clinical outcome was futile recanalization, defined as a 90-day modified Rankin Scale (mRS) 3-6 after successful recanalization. Multivariate regression and mediation analyses were used to assess the relationship between CCC, futile recanalization, and potential mediators. Among 513 patients with successful recanalization, 50.6% (260) experienced futile recanalization. In the multivariable regression analysis, favorable CCC (aOR 0.48, 95% CI 0.31-0.75; P = 0.001) was independently associated with unfavorable outcome despite successful recanalization. Furthermore, mediation analysis revealed that favorable CCC significantly reduced the ischemic core accounting for 27.62% (95% CI 9.69-66.00%) of its beneficial effect on futile recanalization. The benefit of favorable CCC on futile recanalization may be mediated by a reduction in ischemic core volume in AIS patients undergoing EVT. Our findings deepen the understanding of futile recanalization and microcirculation.
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Registered trials
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