Abstract T MP12: Predictors Of Angiographic Collaterals In Patients Undergoing Intra-arterial Therapy For Acute Ischemic Stroke

Abstract

Introduction: Greater degree of collaterals to ischemic brain tissue from large vessel occlusion has been correlated to multiple endpoints including improved outcomes, improved recanalization and smaller infarct volume. The predictors of collateral circulation are poorly understood with inconsistencies in previous studies. Methods: Retrospective study from 1/07-12/12 of AIS patients who underwent IAT for ICA/M1 occlusions with TICI 0/1 flow was conducted. Baseline characteristics and treatment times were collected. Collaterals were graded using the angiographic ASITN collateral-flow grading system. Collateral were grouped into "good collaterals” (GC) for grades 3 and 4, and "poor collaterals" (PC) for grades 0, 1 and 2. Results: ASITN grading was available in 180 patients including 32 (18%) with GC and 148 (82%) with PC. Baseline demographics of all patients and each group are outlined in Table 1, with significant differences in baseline CT ASPECTS score and IV tPA administration. Multivariable logistic regression analysis demonstrated that female sex, CT ASPECTS and time to first angiographic run were the only independent predictors of GC. Conclusions: We have confirmed previous reports that GC is associated with small infarct volume, which corresponds to higher CT ASPECTS score. Odds of GC were 5.7 times in females compared to males, which is inconsistent with previous literature. Previously demonstrated association of hypertension, high admission blood pressure and high NIHSS with lesser collaterals was not seen in our study. Since collaterals affect outcomes in acute ischemic stroke, further studies of predictors of good collaterals are needed.