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KMID : 1130620220180050507
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Journal of Clinical Neurology
2022 Volume.18 No. 5 p.507 ~ p.513
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Collateral Flow in Magnetic Resonance Angiography: Prognostic Value for Vertebrobasilar Stenosis With Stroke Recurrence
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Yan Long
Yu Ying
Kang Kaijiang
Hou Zhikai
Wan Min
Fu Weilun
Cui Rongrong
Wang Yongjun
Miao Zhongrong
Lou Xin
Ma Ning
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Abstract
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Background and Purpose: Intracranial vertebrobasilar atherosclerotic stenosis (IVBAS) is a major cause of posterior circulation stroke. Some patients suffer from stroke recurrence despite receiving medical treatment. This study aimed to determine the prognostic value of a new score for the posterior communicating artery and the P1 segment of the posterior cerebral artery (PCoA-P1) for predicting stroke recurrence in IVBAS.
Methods: We retrospectively enrolled patients with severe IVBAS (70%?99%). According to the number of stroke recurrences, patients were divided into no-recurrence, single-recurrence, and multiple-recurrences groups. We developed a new 5-point grading scale, with the PCoA-P1 score ranging from 0 to 4 based on magnetic resonance angiography, in which primary collaterals were dichotomized into good (2?4 points) and poor (0 or 1 point). Stroke recurrences after the index stroke were recorded. Patients who did not experience stroke recurrence were compared with those who experienced single or multiple stroke recurrences.
Results: From January 2012 to December 2019, 176 patients were enrolled, of which 116 (65.9%) had no stroke recurrence, 35 (19.9%) had a single stroke recurrence, and 25 (14.2%) had multiple stroke recurrences. Patients with single stroke recurrence (odds ratio [OR]=4.134, 95% confidence interval [CI]=1.822?9.380, p=0.001) and multiple stroke recurrences (OR=6.894, 95% CI=2.489?19.092, p<0.001) were more likely to have poor primary collaterals than those with no stroke recurrence.
Conclusions: The new PCoA-P1 score appears to provide improve predictions of stroke recurrence in patients with IVBAS.
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KEYWORD
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posterior cerebral artery, ischemic stroke, magnetic resonance angiography, collateral circulation
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