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Automated evaluation of collateral circulation for outcome prediction in acute ischemic stroke.
Scavasine, Valéria Cristina; Stoliar, Gabriel Abrahao; Teixeira, Bernardo Corrêa de Almeida; Zétola, Viviane de Hiroki Flumignan; Lange, Marcos Christiano.
Afiliação
  • Scavasine VC; Neurology Division, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brazil. Electronic address: valeria.scavasine@hc.ufpr.br.
  • Stoliar GA; Neurology Division, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brazil.
  • Teixeira BCA; Radiology Division, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brazil.
  • Zétola VHF; Neurology Division, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brazil.
  • Lange MC; Neurology Division, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brazil.
J Stroke Cerebrovasc Dis ; 33(4): 107584, 2024 Apr.
Article em En | MEDLINE | ID: mdl-38246577
ABSTRACT

INTRODUCTION:

The assessment of collateral circulation in acute ischemic stroke management is essential. Modern tools, such as Brainomix's e-CTA, powered by artificial intelligence, provide detailed insights into collateral assessment. This retrospective study aims to identify factors contributing to favorable collateral status and compare outcomes between patients with good collaterals (grade 3) and fair collaterals (grade 0-2).

METHOD:

This retrospective study included 97 patients admitted to the Stroke Unit at the Hospital de Clínicas of the Federal University of Paraná, Brazil, from September 2021 to January 2023. Comparative analyses involved demographic factors, cardiovascular risk factors, and the combined outcome of mortality and moderate to severe disability at discharge, 30-day, and 90-day follow-ups.

RESULTS:

Among the 97 cases, 58.8 % showed 'good collaterals' with a grade 3 status. Variables affecting collateral status included age (p = 0.042), neutrophil-lymphocyte ratio (p = 0.005), and initial NIHSS scores (p<0.001). The presence of good collaterals according to e-CTA reduced the odds of death and moderate-severe disability at discharge (p = 0.003; OR 0.27) and at 30 days (p = 0.015; OR 0.33), although this effect diminished at the 90-day mark after multivariate analysis.

DISCUSSION:

Automated collateral assessment through e-CTA is a valuable tool in acute ischemic stroke evaluation. Good e-CTA collateral score serve as a promising imaging biomarker, guiding informed clinical decisions during Stroke Unit hospitalizations. This study highlights the relationship between collaterals and stroke outcomes and underscores the potential for AI-driven tools to enhance stroke care management.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Isquemia Encefálica / Acidente Vascular Cerebral / AVC Isquêmico Idioma: En Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Isquemia Encefálica / Acidente Vascular Cerebral / AVC Isquêmico Idioma: En Ano de publicação: 2024 Tipo de documento: Article