Abstract 3: Quantitative Collateral Vessel Density Associated With the Prognosis of Mechanical Thrombectomy on Intracranial Large Vessel Occlusion: An Initial Study Based on CT Perfusion Imaging

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Objective: This study on acute ischemic stroke caused by large vessel occlusion (LAO) aims to explore the correlation between collateral circulation and the prognosis of mechanical thrombectomy (MT), and further evaluate the high-risk factors of the prognosis of MT by quantitatively measuring the collateral vessel density (CVD) using F-STROKE software. Methods: This study was retrospectively analyzed on 92 patients with acute ischemic stroke caused by LAO from January 2018 to October 2018. All patients underwent MT and CT perfusion (CTP) examination before operation. mRS evaluation was performed after 90 days. The patients were divided into two groups according to 90d-mRS (0-2 points: good prognosis; 3-6 points: poor prognosis) F-stroke software was used for CTP image analysis to quantitatively obtain core infarct volume, ischemic penumbra volume, mismatch ratio and CVD (CVD = the vessel volume of the hypoperfusion region / the volume of the hypoperfusion region). Multivariate logistic regression model was used for statistical analysis. Results: A total of 87 patients with LAO were included in this study, including 54 patients with good prognosis. The univariate analysis showed that core infarction volume (P=0.017), mismatch ratio (P=0.040), CVD (P=0.003) and symptom improvement (P<0.001) were associated with the prognosis after MT. As multivariate Logistic regression analysis shown, CVD (P=0.008; OR=13.296; 95%CI, 1.948-90.736) and symptom improvement (P=0.003; OR=13.824; 95%CI, 2.476-77.196) were two independent high-risk factors of the prognosis of MT. According to ROC (figure 1), the AUC value of CVD and symptom improvement were 0.839 and 0.790, respectively. When combining both of the two features to predict the prognosis of thrombolysis, the AUC value has been improved to 0.887. Conclusion: For patients with LAO who underwent MT, CVD was an independent quantitative predictor to the prognosis after MT surgery.