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The following is a summary of “Recruitment of pial collaterals and carotid occlusive disease in large-vessel occlusion ischemic stroke,” published in the October 2024 issue of Neurology by Helwig et al.
Pial collateral vessels play a crucial role in limiting ischemic injury during acute large vessel occlusion (LVO) stroke. Yet, variations in collateral supply among individuals remain poorly understood due to factors like chronic carotid occlusive disease.
Researchers conducted a retrospective study to investigate the association between quantitatively assessed pial collateral supply and pre-existing carotid stenosis in patients with acute stroke caused by LVO.
They included patients with proximal, middle cerebral artery (MCA) occlusion (n = 98, mean age 68.8 ± 16.1 years), assessing collateral supply based on a signal variance in T2*-weighted time series during perfusion-weighted magnetic resonance imaging (PWI). Patients were stratified into 2 groups, poor collateral supply and fair to good collateral supply.
The results showed no significant difference in the prevalence of ipsilateral high-grade internal carotid artery (ICA) stenosis between the groups, with 6 (14.3%) patients in the poor collateral supply group and 12 (21.1%) in the fair to good collateral supply group (OR 1.58, 95%CI 0.490–5.685, P=0.440). Additionally, collateral supply was significantly correlated with initial stroke severity (r = −0.360, P<0.001), baseline ischemic core volume (r = −0.362, P<0.001), and early functional outcomes as measured by the modified Rankin Scale (r = −0.367, P<0.01).
They concluded that quantitative MRI-based assessments of pial collateral supply do not significantly differ regarding pre-existing high-grade ICA stenosis, suggesting a need for further exploration of demographic and clinical factors affecting collateral supply in acute stroke.
Source: frontiersin.org/journals/neurology/articles/10.3389/fneur.2024.1423967/full
