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Research ArticleBrain

Collateral Score Complements Clot Location in Predicting the Outcome of Intravenous Thrombolysis

J.T. Saarinen, H. Rusanen and N. Sillanpää
American Journal of Neuroradiology October 2014, 35 (10) 1892-1896; DOI: https://doi.org/10.3174/ajnr.A3983
J.T. Saarinen
aFrom the Department of Neurology (J.T.S.), University of Tampere, Tampere and Vaasa Central Hospital, Vaasa, Finland
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H. Rusanen
bDepartment of Neurology (H.R.), Oulu University Hospital, Oulu, Finland
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N. Sillanpää
cMedical Imaging Center (N.S.), Tampere University Hospital, Tampere, Finland.
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    Fig 1.

    The distribution of collateral scores in different clot locations. Collateral scores 3 and 4 are pooled into same group.

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    Fig 2.

    Collateral score and the site of the occlusion predict the clinical outcome. A proximal clot (ICA or M1P) is more strongly associated with unfavorable outcome than poor collateral status (CS 0–1).

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    Table 1:

    Demographic and baseline characteristics of all patients and by good collateral status, the locus of the thrombus, and 3-month outcome

    CharacteristicAll Patients (n = 105)Collateral Score 0–1 (n = 47)Collateral Score 2–4 (n = 58)P1mRS ≤2 at Day 90 (n = 54)mRS 3–6 at Day 90 (n = 50)P2Proximal Thrombus (ICA+M1P, n = 38)Distal Thrombus (M1D+M2+M3, n = 67)P3
    Age (yr) (mean) (SD)68.8 (13.5)70.1 (14.4)67.8 (12.7).3866.4 (13.1)71.3 (13.6).0666.0 (15.1)70.4 (12.3).11
    Male (%)60 (57)29 (62)31 (53).4032 (59)28 (56).7427 (71)33 (49).03
    NIHSS score before treatment (median) (IQR)13 (10)15 (7)11 (12).029 (10)17 (7)<.00118 (7)11 (10)<.001
    NIHSS score 24 hours after thrombolysis (median) (IQR)6 (14)14 (14)3 (7)<.0012 (4)16 (11)<.00115 (10)3 (7)<.001
    ASPECTS at admission CT (median) (IQR)10 (2)8 (3)10 (0)<.00110 (1)9 (2).209 (3)10 (2).07
    ASPECTS at 24 hours after CT (median) (IQR)7 (5)5 (4)8.5 (3)<.0019 (3)5 (4)<.0014 (5)8 (4)<.001
    Collateral score (median) (IQR)2 (3)0 (1)3 (1)<.0013 (1)1 (2)<.0011 (3)2 (2).01
    Onset-to-treatment time (min) (mean) (SD)132 (27)124 (26)138 (27).008133 (26)129 (29).46131 (31)132 (25).85
    Hypertension (No.) (%)69 (65.7)31 (66)38 (66).9636 (66.7)33 (66.0).9422 (57.9)47 (70.1).20
    Diabetes (No.) (%)17 (16.2)9 (19)8 (14).466 (11.1)11 (22.0).138 (21.1)9 (13.4).31
    Atrial fibrillation (No.) (%)41 (39.0)19 (40)22 (38).7923 (42.6)18 (36.0).4912 (31.6)29 (43.3).24
    Coronary artery disease (No.) (%)35 (33.3)19 (40)16 (28).1712 (22.2)23 (46.0).0116 (42.1)19 (28.4).15
    • Note:—P1 indicates a P value between poor and good collateral status; P2, P value between mRS ≤ 2 and mRS > 2 groups; P3, P value between the proximal and distal thrombus groups; IQR, interquartile range; min, minutes.

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    Table 2:

    Logistic regression analysis for favorable clinical outcomea

    mRS ≤2 at 2 Months
    Odds Ratio95% CIP Value
    Clot location––.003
        ICArefref–
        M1 proximal10.10.74–140.08
        M1 distal33.82.9–428.007
        M2 and M3115.87.7–1737.001
    Onset-to-treatment time0.990.97–1.02.44
    Sex0.340.09–1.3.11
    Age0.950.90–0.99.02
    Admission NIHSS score0.810.71–0.92.001
    Favorable CS (2–4)9.32.4–35.8.001
    • Note:—ref indicates reference location; –, not applicable.

    • ↵a Odds ratios are per minute for onset-to-treatment time, per year for age, and per 1 point for NIHSS.

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American Journal of Neuroradiology: 35 (10)
American Journal of Neuroradiology
Vol. 35, Issue 10
1 Oct 2014
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J.T. Saarinen, H. Rusanen, N. Sillanpää
Collateral Score Complements Clot Location in Predicting the Outcome of Intravenous Thrombolysis
American Journal of Neuroradiology Oct 2014, 35 (10) 1892-1896; DOI: 10.3174/ajnr.A3983

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Collateral Score Complements Clot Location in Predicting the Outcome of Intravenous Thrombolysis
J.T. Saarinen, H. Rusanen, N. Sillanpää
American Journal of Neuroradiology Oct 2014, 35 (10) 1892-1896; DOI: 10.3174/ajnr.A3983
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