Cerebral small vessel disease does not impair leptomeningeal collateral supply in large-vessel occlusion - Results from quantitative collateral mapping with MRI.

We hypothesized that cerebral small vessel disease (CSVD) burden might not relevantly affect leptomeningeal collateral supply in patients with acute ischemic stroke (AIS) due to large-vessel occlusion (LVO). In n = 154 patients with anterior circulation LVO, CSVD imaging markers (white matter hyperintensities [WMH], lacunes, cerebral microbleeds and enlarged perivascular spaces) were assessed with MRI, using established criteria. Besides the extent of WMH, assessed using total Fazekas sum score, overall CSVD burden was determined with a total CSVD summary score ranging from 0-4.

Recruitment of pial collaterals and carotid occlusive disease in large-vessel occlusion ischemic stroke.

Background And Purpose: Despite the fundamental role of pial collateral vessels in limiting the progression of ischemic tissue injury in acute stroke with large vessel occlusion (LVO), in addition to the fact that collateral vessel abundance varies naturally from person to person for genetic reasons, there is limited knowledge regarding potential factors contributing to inherent interindividual variation in pial collateral supply. As it has been repeatedly hypothesized that chronic carotid occlusive disease may favor pial collateralization, we aimed to investigate the association between quantitatively assessed leptomeningeal collateral supply and pre-existing carotid stenosis in patients with acute stroke due to LVO.

Materials And Methods: Patients with proximal middle cerebral artery (MCA) occlusion with or without additional internal carotid artery (ICA) occlusion were included.

MRI-based Quantitative Collateral Assessment in Acute Stroke : A Comparison with Single-phase CTA in Drip-and-ship Patients with Serial Imaging.

Purpose: In acute ischemic stroke with large-vessel occlusion (LVO), collateral assessment with single-phase computed tomography angiography (CTA) might underestimate pial collateral supply in a considerable proportion of patients. We aimed to compare time-resolved magnetic resonance imaging (MRI)-based quantitative collateral mapping to conventional collateral imaging with CTA.

Methods: This retrospective single-center study covering a period of 6 years (2012-2018) included drip-and-ship LVO patients who underwent MR imaging after initial imaging evaluation with CT.