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Neurology International
Volume 16
Issue 3
10.3390/neurolint16030046
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Article

Communicating Arteries and Leptomeningeal Collaterals: A Synergistic but Independent Effect on Patient Outcomes after Stroke

by
Sara Sablić
1,
Krešimir Dolić
1,2,3,
Danijela Budimir Mršić
1,2,
Mate Čičmir-Vestić
4,
Antonela Matana
3,
Sanja Lovrić Kojundžić
1,2,3 and
Maja Marinović Guić
1,2,3,*
1
Clinical Department of Diagnostic and Interventional Radiology, University Hospital of Split, 21000 Split, Croatia
2
School of Medicine, University of Split, 21000 Split, Croatia
3
University Department of Health Studies, University of Split, 21000 Split, Croatia
4
Department of Neurology, University Hospital of Split, 21000 Split, Croatia
*
Author to whom correspondence should be addressed.
Neurol. Int. 2024, 16(3), 620-630; https://doi.org/10.3390/neurolint16030046
Submission received: 25 April 2024 / Revised: 29 May 2024 / Accepted: 29 May 2024 / Published: 2 June 2024
(This article belongs to the Special Issue Treatment Strategy and Mechanism of Acute Ischemic Stroke)
Review Reports Versions Notes

Abstract

The collateral system is a compensatory mechanism activated in the acute phase of an ischemic stroke. It increases brain perfusion to the hypoperfused area. Arteries of the Willis’ circle supply antegrade blood flow, while pial (leptomeningeal) arteries direct blood via retrograde flow. The aim of our retrospective study was to investigate the relationship between both collateral systems, computed tomography perfusion (CTP) values, and functional outcomes in acute stroke patients. Overall, 158 patients with anterior circulation stroke who underwent mechanical thrombectomy were included in the study. We analyzed the presence of communicating arteries and leptomeningeal arteries on computed tomography angiography. Patients were divided into three groups according to their collateral status. The main outcomes were the rate of functional independence 3 months after stroke (modified Rankin scale score, mRS) and mortality rate. Our study suggests that the collateral status, as indicated by the three groups (unfavorable, intermediate, and favorable), is linked to CT perfusion parameters, potential recuperation ratio, and stroke outcomes. Patients with favorable collateral status exhibited smaller core infarct and penumbra volumes, higher mismatch ratios, better potential for recuperation, and improved functional outcomes compared to patients with unfavorable or intermediate collateral status.
Keywords: cerebral infarction; stroke; mechanical thrombectomy; endovascular treatment; collateral circulation cerebral infarction; stroke; mechanical thrombectomy; endovascular treatment; collateral circulation

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MDPI and ACS Style

Sablić, S.; Dolić, K.; Budimir Mršić, D.; Čičmir-Vestić, M.; Matana, A.; Lovrić Kojundžić, S.; Marinović Guić, M. Communicating Arteries and Leptomeningeal Collaterals: A Synergistic but Independent Effect on Patient Outcomes after Stroke. Neurol. Int. 2024, 16, 620-630. https://doi.org/10.3390/neurolint16030046

AMA Style

Sablić S, Dolić K, Budimir Mršić D, Čičmir-Vestić M, Matana A, Lovrić Kojundžić S, Marinović Guić M. Communicating Arteries and Leptomeningeal Collaterals: A Synergistic but Independent Effect on Patient Outcomes after Stroke. Neurology International. 2024; 16(3):620-630. https://doi.org/10.3390/neurolint16030046

Chicago/Turabian Style

Sablić, Sara, Krešimir Dolić, Danijela Budimir Mršić, Mate Čičmir-Vestić, Antonela Matana, Sanja Lovrić Kojundžić, and Maja Marinović Guić. 2024. "Communicating Arteries and Leptomeningeal Collaterals: A Synergistic but Independent Effect on Patient Outcomes after Stroke" Neurology International 16, no. 3: 620-630. https://doi.org/10.3390/neurolint16030046

APA Style

Sablić, S., Dolić, K., Budimir Mršić, D., Čičmir-Vestić, M., Matana, A., Lovrić Kojundžić, S., & Marinović Guić, M. (2024). Communicating Arteries and Leptomeningeal Collaterals: A Synergistic but Independent Effect on Patient Outcomes after Stroke. Neurology International, 16(3), 620-630. https://doi.org/10.3390/neurolint16030046

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