title: CT perfusion and angiographic assessment of pial collateral reperfusion in acute ischemic stroke: the CAPRI study.
abstract: BACKGROUND
  The purpose of this study was to evaluate the correlation between a novel angiographic score for collaterals and CT perfusion (CTP) parameters in patients undergoing endovascular treatment for acute ischemic stroke (AIS).
  
  
  METHODS
  103 patients (mean age 66.7±12.7; 48.5% men) with AIS in the anterior circulation territory, imaged with non-contrast CT, CT angiography, and CTP, admitted within 8 h from symptom onset and treated with any endovascular approach, were retrospectively included in the study. Clinical, neuroradiological data, and all time intervals were collected. Careggi Collateral Score (CCS) was used for angiographic assessment of collaterals and the Alberta Stroke Program Early CT Score (ASPECTS) for semiquantitative analysis of CTP maps. Two centralized core laboratories separately reviewed angiographic data, whereas CT findings were evaluated by an expert neuroradiologist. Univariate and multivariate analysis were performed considering CCS both as an ordinal and a dichotomous variable.
  
  
  RESULTS
  37/103 patients (35.9%) received intravenous tissue plasminogen activator. Median (IQR) ASPECTS was 9 (6-10) for admission CT, 9 (5-10) for cerebral blood volume (CBV) maps, 3 (2-3) for mean transit time maps, 3 (2-4), for cerebral blood flow maps, and 5 (3-7) for CTP mismatch. Univariate analysis showed a significant correlation between CCS and ASPECTS for all CTP parameters. Multivariate analysis confirmed an independent association only between CCS and CBV (p=0.020 when CCS was considered as a dichotomous variable, p=0.026 with ordinal CCS).
  
  
  CONCLUSIONS
  A correlation between angiographic assessment of the collateral circulation and CTP seems to be present, suggesting that CCS may provide an indirect evaluation of the infarct core volume to consider for patient selection in AIS.
authors.affiliation: Interventional Neuroradiology Unit, Careggi University Hospital, Florence, Italy.
authors.forename: Arturo
authors.initials: A
authors.lastname: Consoli
authors.affiliation: Departments of Radiology and Neurology, AZ Groeninge, Kortrijk, Belgium.|Department of Neuroradiology, Karolinska University Hospital, and Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Tommy
authors.initials: T
authors.lastname: Andersson
authors.affiliation: Department of Neuroradiology, Karolinska University Hospital, and Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Ake
authors.initials: A
authors.lastname: Holmberg
authors.affiliation: Department of Neuroradiology, Nuovo Ospedale Civile 'S Agostino-Estense', Modena, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Verganti
authors.affiliation: Neuroradiology Unit, Azienda Ospedaliero-Universitaria of Ferrara, Cona, Ferrara, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Saletti
authors.affiliation: Department of Neuroradiology, Nuovo Ospedale Civile 'S Agostino-Estense', Modena, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Vallone
authors.affiliation: Stroke Unit, Department of Neuroscience, Nuovo Ospedale Civile 'S Agostino-Estense', Modena, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Zini
authors.affiliation: Unit of Neuroimaging and Neurointervention, Policlinico 'Santa Maria alle Scotte,', Siena, Italy.
authors.forename: Alfonso
authors.initials: A
authors.lastname: Cerase
authors.affiliation: Unit of Neuroimaging and Neurointervention, Policlinico 'Santa Maria alle Scotte,', Siena, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Romano
authors.affiliation: Unit of Neuroimaging and Neurointervention, Policlinico 'Santa Maria alle Scotte,', Siena, Italy.
authors.forename: Sandra
authors.initials: S
authors.lastname: Bracco
authors.affiliation: Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy.
authors.forename: Svetlana
authors.initials: S
authors.lastname: Lorenzano
authors.affiliation: Neuroradiology Unit, Azienda Ospedaliero-Universitaria of Ferrara, Cona, Ferrara, Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Fainardi
authors.affiliation: Interventional Neuroradiology Unit, Careggi University Hospital, Florence, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Mangiafico
keywords: Angiography; CT perfusion; Stroke