Collateral status reperfusion and outcomes after endovascular therapy: insight from the Endovascular Treatment in Ischemic Stroke (ETIS) Registry
Mohammad Anadani
(1, 2)
,
Stephanos Finitsis
(3)
,
Frédéric Clarençon
(4)
,
Sébastien Richard
(5)
,
Gaultier Marnat
(6)
,
Romain Bourcier
(7)
,
Igor Sibon
(6)
,
Cyril Dargazanli
(8)
,
Caroline Arquizan
(8)
,
Raphael Blanc
(9)
,
Bertrand Lapergue
(10)
,
Arturo Consoli
(11, 12)
,
Francois Eugene
(13)
,
Stephane Vannier
(14)
,
Laurent Spelle
(15)
,
Christian Denier
(15)
,
Marion Boulanger
(16)
,
Maxime Gauberti
(17)
,
David Liebeskind
(18)
,
Adam de Havenon
(19)
,
Suzana Saleme
(20)
,
Francisco Macian
(20)
,
Charlotte Rosso
(4)
,
Olivier Naggara
(17)
,
Guillaume Turc
(17)
,
Ozlem Ozkul-Wermester
(21)
,
Chrisanthi Papagiannaki
(21)
,
Alain Viguier
(22)
,
Christophe Cognard
(23)
,
Anthony Le Bras
(14, 24)
,
Sarah Evain
(24)
,
Valerie Wolff
(25)
,
Raoul Pop
(25)
,
Serge Timsit
(26)
,
Jean-Christophe Gentric
(26)
,
Frédéric Bourdain
(27)
,
Louis Veunac
(27)
,
Benjamin Maier
(9)
,
Benjamin Gory
(28)
,
Etis Registry Investigators
,
Vincent Costalat
(8, 29)
,
Adrien Ter Schiphorst
(8, 29)
1
Washington University School of Medicine [Saint Louis, MO]
2 MUSC - Medical University of South Carolina [Charleston]
3 AHEPA University General Hospital [Thessaloniki]
4 CHU Pitié-Salpêtrière [AP-HP]
5 Service de neurologie [CHRU Nancy]
6 CHU Bordeaux
7 CHU Nantes - Centre Hospitalier Universitaire de Nantes = Nantes University Hospital
8 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
9 Fondation Ophtalmologique Adolphe de Rothschild [Paris]
10 Hôpital Foch [Suresnes]
11 Service de neuroradiologie [Suresnes]
12 AOUC - Azienda Ospedaliero Universitaria Careggi [Firenze] = Careggi University Hospital [Florence, Italy]
13 Service de Neuroradiologie [Rennes]
14 Service de Neurologie [CHU Rennes]
15 Hôpital Bicêtre [AP-HP, Le Kremlin-Bicêtre]
16 CHU Caen
17 Centre Hospitalier Sainte Anne [Paris]
18 UCLA - University of California [Los Angeles]
19 University of Utah
20 CHU Limoges
21 CHU Rouen
22 Département Neurologie [CHU Toulouse]
23 Service Neuroradiologie Diagnostique et Thérapeutique [CHU Toulouse]
24 CHBA - Centre hospitalier Bretagne Atlantique (Morbihan)
25 CHU Strasbourg - Centre Hospitalier Universitaire [Strasbourg]
26 CHRU Brest - Centre Hospitalier Régional Universitaire de Brest
27 CHCB - Centre Hospitalier de la Côte Basque
28 CHRU Nancy - Centre Hospitalier Régional Universitaire de Nancy
29 UM - Université de Montpellier
2 MUSC - Medical University of South Carolina [Charleston]
3 AHEPA University General Hospital [Thessaloniki]
4 CHU Pitié-Salpêtrière [AP-HP]
5 Service de neurologie [CHRU Nancy]
6 CHU Bordeaux
7 CHU Nantes - Centre Hospitalier Universitaire de Nantes = Nantes University Hospital
8 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
9 Fondation Ophtalmologique Adolphe de Rothschild [Paris]
10 Hôpital Foch [Suresnes]
11 Service de neuroradiologie [Suresnes]
12 AOUC - Azienda Ospedaliero Universitaria Careggi [Firenze] = Careggi University Hospital [Florence, Italy]
13 Service de Neuroradiologie [Rennes]
14 Service de Neurologie [CHU Rennes]
15 Hôpital Bicêtre [AP-HP, Le Kremlin-Bicêtre]
16 CHU Caen
17 Centre Hospitalier Sainte Anne [Paris]
18 UCLA - University of California [Los Angeles]
19 University of Utah
20 CHU Limoges
21 CHU Rouen
22 Département Neurologie [CHU Toulouse]
23 Service Neuroradiologie Diagnostique et Thérapeutique [CHU Toulouse]
24 CHBA - Centre hospitalier Bretagne Atlantique (Morbihan)
25 CHU Strasbourg - Centre Hospitalier Universitaire [Strasbourg]
26 CHRU Brest - Centre Hospitalier Régional Universitaire de Brest
27 CHCB - Centre Hospitalier de la Côte Basque
28 CHRU Nancy - Centre Hospitalier Régional Universitaire de Nancy
29 UM - Université de Montpellier
Mohammad Anadani
- Fonction : Auteur
- PersonId : 801468
- ORCID : 0000-0002-7813-2949
Sébastien Richard
- Fonction : Auteur
- PersonId : 776166
- ORCID : 0000-0002-0945-5656
Cyril Dargazanli
- Fonction : Auteur
- PersonId : 786393
- ORCID : 0000-0003-1891-9157
- IdRef : 150524501
Raphael Blanc
- Fonction : Auteur
- PersonId : 767098
- ORCID : 0000-0002-3975-3865
- IdRef : 074484559
Arturo Consoli
- Fonction : Auteur
- PersonId : 786640
- ORCID : 0000-0001-6640-8541
Francois Eugene
- Fonction : Auteur
- PersonId : 766686
- ORCID : 0000-0001-7367-8793
- IdRef : 170423107
Laurent Spelle
- Fonction : Auteur
- PersonId : 767049
- ORCID : 0000-0002-6748-8528
- IdRef : 085614475
Christian Denier
- Fonction : Auteur
- PersonId : 773698
- ORCID : 0000-0002-2087-5563
David Liebeskind
- Fonction : Auteur
- PersonId : 786400
- ORCID : 0000-0002-5109-8736
Olivier Naggara
- Fonction : Auteur
- PersonId : 762647
- ORCID : 0000-0002-9544-379X
- IdRef : 07473637X
Guillaume Turc
- Fonction : Auteur
- PersonId : 776614
- ORCID : 0000-0001-5059-4095
- IdRef : 098880470
Alain Viguier
- Fonction : Auteur
- PersonId : 1366509
- ORCID : 0000-0002-0324-3783
Anthony Le Bras
- Fonction : Auteur
- PersonId : 762879
- ORCID : 0000-0001-5691-3894
- IdRef : 18432078X
Raoul Pop
- Fonction : Auteur
- PersonId : 774650
- ORCID : 0000-0003-4417-1496
Serge Timsit
- Fonction : Auteur
- PersonId : 958724
- ORCID : 0000-0003-0346-8576
- IdRef : 035207884
Jean-Christophe Gentric
- Fonction : Auteur
- PersonId : 766510
- ORCID : 0000-0002-1655-1371
Benjamin Gory
- Fonction : Auteur
- PersonId : 762859
- ORCID : 0000-0001-8424-4464
Etis Registry Investigators
- Fonction : Auteur
Vincent Costalat
- Fonction : Collaborateur
- PersonId : 1056305
Adrien Ter Schiphorst
- Fonction : Collaborateur
Résumé
Background Studies have suggested that collateral status modifies the effect of successful reperfusion on functional outcome after endovascular therapy (EVT). We aimed to assess the association between collateral status and EVT outcomes and to investigate whether collateral status modified the effect of successful reperfusion on EVT outcomes. Methods We used data from the ongoing, prospective, multicenter Endovascular Treatment in Ischemic Stroke (ETIS) Registry. Collaterals were graded according to the American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology (ASITN/SIR) guidelines. Patients were divided into two groups based on angiographic collateral status: poor (grade 0–2) versus good (grade 3–4) collaterals. Results Among 2020 patients included in the study, 959 (47%) had good collaterals. Good collaterals were associated with favorable outcome (90-day modified Rankin Scale (mRS) 0–2) (OR 1.5, 95% CI 1.19 to 1.88). Probability of good outcome decreased with increased time from onset to reperfusion in both good and poor collateral groups. Successful reperfusion was associated with higher odds of favorable outcome in good collaterals (OR 6.01, 95% CI 3.27 to 11.04) and poor collaterals (OR 5.65, 95% CI 3.32 to 9.63) with no significant interaction. Similarly, successful reperfusion was associated with higher odds of excellent outcome (90-day mRS 0–1) and lower odds of mortality in both groups with no significant interaction. The benefit of successful reperfusion decreased with time from onset in both groups, but the curve was steeper in the poor collateral group. Conclusions Collateral status predicted functional outcome after EVT. However, collateral status on the pretreatment angiogram did not decrease the clinical benefit of successful reperfusion.