THE CHARACTERISTICS OF BRAIN PARENCHYMAL DAMAGE AND COLLATERAL CIRCULATION ON 3-PHASE CTA IN PATIENTS WITH LARGE CEREBRAL ARTERY OCCLUSION

Đức Thuần Đỗ1,, Anh Tuấn Phùng 1, Thanh Tuấn Nguyễn2, Thị lệ Thu Nguyễn2
1 103 Military Hospital
2 Vietnam Military Medical Academy

Main Article Content

Abstract

Objective: To evaluate the characteristics of brain parenchymal damage and collateral circulation on 3-phase CTA in patients with large cerebral artery occlusion. Subjects and research methods: prospective, cross-sectional study, 94 patients with large cerebral artery occlusion in the first 7 days, treated at the Stroke Department, 103 Military Hospital, from September 2021 to May 4 in 2023. Results: The rate of occlusion of the middle cerebral artery (M1,2) is 53%, the internal carotid artery (ICA) is 26%, the M1,2 and the ICA is 17%; The basilar artery (BA) is 4%. 55.3% had no lesion image on CT scan: 13.8% had large density loss ≥ 30ml. The group with CT scan ≤ 6 hours had ASPECTS score ≥7 accounted for 93.8%; 65.4% higher than the group with CT scan > 6 hours with p < 0.05. The rate of good collateral status on 3-phase CTA according to the location of the occlusion was highest in the group of simple ICA occlusion with 29.2%; the lowest is BA occlusion with 0%; p>0.05. Conclusion: M1 occlusion was common 53%, 55.3% had no lesion image on CT scan, ASPECTS score ≥7 in the group who went to hospital before 6 hours accounted for a higher rate than those who went to hospital after 6 o'clock. The collateral circulation due to good ICA occlusion accounted for the highest rate of 29.2%.

Article Details

References

1. Waqas, M., et al., Large vessel occlusion in acute ischemic stroke patients: a dual-center estimate based on a broad definition of occlusion site. Journal of Stroke and Cerebrovascular Diseases, 2020. 29(2): p. 104504.
2. Nambiar, V., et al., CTA collateral status and response to recanalization in patients with acute ischemic stroke. American Journal of Neuroradiology, 2014. 35(5): p. 884-890.
3. Menon, B.K., et al., Multiphase CT angiography: a new tool for the imaging triage of patients with acute ischemic stroke. Radiology, 2015. 275(2): p. 510-520.
4. van der Hoeven, E.J., et al., Collateral flow predicts outcome after basilar artery occlusion: the posterior circulation collateral score. International Journal of Stroke, 2016. 11(7): p. 768-775.
5. Paciaroni, M., et al., Outcome in patients with stroke associated with internal carotid artery occlusion. Cerebrovasc Dis, 2005. 20(2): p. 108-13.
6. Kwak, H.S. and J.S. Park, Mechanical thrombectomy in basilar artery occlusion: clinical outcomes related to posterior circulation collateral score. Stroke, 2020. 51(7): p. 2045-2050.
7. Tao, C., et al., Trial of Endovascular Treatment of Acute Basilar-Artery Occlusion. 2022. 387(15): p. 1361-1372.
8. Alves, H.C.B.R., F.T. Pacheco, and A.J. Rocha, Collateral blood vessels in acute ischemic stroke: a physiological window to predict future outcomes. Arquivos de neuro-psiquiatria, 2016. 74: p. 662-670.