TY - JOUR
T1 - Intracranial carotid artery calcification subtype and collaterals in patients undergoing endovascular thrombectomy
AU - Luijten, Sven P. R.
AU - van der Donk, Sophie C.
AU - Compagne, Kars C. J.
AU - Yo, Lonneke S. F.
AU - Sprengers, Marieke E. S.
AU - Majoie, Charles B. L. M.
AU - Roos, Yvo B. W. E. M.
AU - van Zwam, Wim H.
AU - van Oostenbrugge, Robert
AU - Dippel, Diederik W. J.
AU - van der Lugt, Aad
AU - Roozenbeek, Bob
AU - MR CLEAN Registry Investigators
AU - Bos, Daniel
N1 - Funding Information: Dr Majoie reports that he is a shareholder of NICO.LAB and grants from CVON/Dutch Heart Foundation, European Commission, TWIN Foundation, and Stryker, all paid to institution. Dr Roos reports that he is a shareholder of NICO.LAB. Dr van Zwam reports grants from Stryker and Cerenovus, all paid to institution. Dr Dippel reports grants from the Dutch Heart Foundation, Brain Foundation Netherlands, The Netherlands Organisation for Health Researce and Development, Health Holland Top Sector Life Sciences and Health, and grants from Penumbra, Stryker, Medtronic, Thrombolytic Science, LLC, and Cerenovus, all paid to institution. Dr van der Lugt reports grants from Penumbra, Stryker, Cerenovus, and Medtronic, all paid to institution. The other authors report no disclosures. Funding Information: The MR CLEAN Registry was partly funded by TWIN Foundation , Erasmus MC University Medical Center , Maastricht University Medical Center , and Amsterdam University Medical Center . Publisher Copyright: © 2021 The Authors
PY - 2021/11/1
Y1 - 2021/11/1
N2 - Background and aims: Distinct subtypes of intracranial carotid artery calcification (ICAC) have been found (i.e., medial and intimal), which may differentially be associated with the formation of collaterals. We investigated the association of ICAC subtype with collateral status in patients undergoing endovascular thrombectomy (EVT) for ischemic stroke. We further investigated whether ICAC subtype modified the association between collateral status and functional outcome. Methods: We used data from 2701 patients with ischemic stroke undergoing EVT. Presence and subtype of ICAC were assessed on baseline non-contrast CT. Collateral status was assessed on baseline CT angiography using a visual scale from 0 (absent) to 3 (good). We investigated the association of ICAC subtype with collateral status using ordinal and binary logistic regression. Next, we assessed whether ICAC subtype modified the association between collateral status and functional outcome (modified Rankin Scale, 0–6). Results: Compared to patients without ICAC, we found no association of intimal or medial ICAC with collateral status (ordinal variable). When collateral grades were dichotomized (3 versus 0–2), we found that intimal ICAC was significantly associated with good collaterals in comparison to patients without ICAC (aOR, 1.41 [95%CI:1.06–1.89]) or with medial ICAC (aOR, 1.50 [95%CI:1.14–1.97]). The association between higher collateral grade and better functional outcome was significantly modified by ICAC subtype (p for interaction = 0.01). Conclusions: Patients with intimal ICAC are more likely to have good collaterals and benefit more from an extensive collateral circulation in terms of functional outcome after EVT.
AB - Background and aims: Distinct subtypes of intracranial carotid artery calcification (ICAC) have been found (i.e., medial and intimal), which may differentially be associated with the formation of collaterals. We investigated the association of ICAC subtype with collateral status in patients undergoing endovascular thrombectomy (EVT) for ischemic stroke. We further investigated whether ICAC subtype modified the association between collateral status and functional outcome. Methods: We used data from 2701 patients with ischemic stroke undergoing EVT. Presence and subtype of ICAC were assessed on baseline non-contrast CT. Collateral status was assessed on baseline CT angiography using a visual scale from 0 (absent) to 3 (good). We investigated the association of ICAC subtype with collateral status using ordinal and binary logistic regression. Next, we assessed whether ICAC subtype modified the association between collateral status and functional outcome (modified Rankin Scale, 0–6). Results: Compared to patients without ICAC, we found no association of intimal or medial ICAC with collateral status (ordinal variable). When collateral grades were dichotomized (3 versus 0–2), we found that intimal ICAC was significantly associated with good collaterals in comparison to patients without ICAC (aOR, 1.41 [95%CI:1.06–1.89]) or with medial ICAC (aOR, 1.50 [95%CI:1.14–1.97]). The association between higher collateral grade and better functional outcome was significantly modified by ICAC subtype (p for interaction = 0.01). Conclusions: Patients with intimal ICAC are more likely to have good collaterals and benefit more from an extensive collateral circulation in terms of functional outcome after EVT.
KW - Collateral status
KW - Endovascular thrombectomy
KW - Intracranial carotid artery calcification
KW - Ischemic stroke
UR - http://www.scopus.com/inward/record.url?scp=85117134068&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.atherosclerosis.2021.10.005
DO - https://doi.org/10.1016/j.atherosclerosis.2021.10.005
M3 - Article
C2 - 34662837
SN - 0021-9150
VL - 337
SP - 1
EP - 6
JO - Atherosclerosis
JF - Atherosclerosis
ER -