Stroke Aetiology and Collateral Status in Acute Ischemic Stroke Patients Receiving Reperfusion Therapy-A Meta-Analysis

Background: The interplay between collateral status and stroke aetiology may be crucial in the evaluation and management of acute ischemic stroke (AIS). Our understanding of this relationship and its level of association remains sub-optimal. This study sought to examine the association of pre-interv...

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Main Authors: Akansha Sinha (Author), Peter Stanwell (Author), Roy G. Beran (Author), Zeljka Calic (Author), Murray C. Killingsworth (Author), Sonu M. M. Bhaskar (Author)
Format: Book
Published: MDPI AG, 2021-11-01T00:00:00Z.
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001 doaj_cde4461b0fd44b92b7dc10acff1be82d
042 |a dc 
100 1 0 |a Akansha Sinha  |e author 
700 1 0 |a Peter Stanwell  |e author 
700 1 0 |a Roy G. Beran  |e author 
700 1 0 |a Zeljka Calic  |e author 
700 1 0 |a Murray C. Killingsworth  |e author 
700 1 0 |a Sonu M. M. Bhaskar  |e author 
245 0 0 |a Stroke Aetiology and Collateral Status in Acute Ischemic Stroke Patients Receiving Reperfusion Therapy-A Meta-Analysis 
260 |b MDPI AG,   |c 2021-11-01T00:00:00Z. 
500 |a 10.3390/neurolint13040060 
500 |a 2035-8377 
520 |a Background: The interplay between collateral status and stroke aetiology may be crucial in the evaluation and management of acute ischemic stroke (AIS). Our understanding of this relationship and its level of association remains sub-optimal. This study sought to examine the association of pre-intervention collateral status with stroke aetiology, specifically large artery atherosclerosis (LAA) and cardio-embolism (CE), in AIS patients receiving reperfusion therapy, by performing a meta-analysis. Methods: Relevant search terms were explored on Medline/PubMed, Embase and Cochrane databases. Studies were included using the following inclusion criteria: (a) patients aged 18 or above; (b) AIS patients; (c) patients receiving reperfusion therapy; (d) total cohort size of >20, and (e) qualitative or quantitative assessment of pre-intervention collateral status on imaging using a grading scale. Random-effects meta-analysis was performed to investigate the association of aetiology with pre-intervention collateral status, and forest plots of risk ratio (RR) were generated. Results: A meta-analysis was conducted on seven studies, with a cumulative cohort of 1235 patients, to assess the association of pre-intervention collateral status with stroke aetiology. Patients with LAA were associated significantly with an increased rate of good collaterals (RR 1.24; 95% CI 1.04-1.50; <i>p</i> = 0.020, z = 2.33). Contrarily, CE aetiology was associated significantly with a decreased rate of good collaterals (RR 0.83; 95% CI 0.71-0.98; <i>p</i> = 0.027, z = −2.213). Conclusions: This study demonstrates that, in AIS patients receiving reperfusion therapy, LAA and CE aetiologies are associated significantly with collateral status. 
546 |a EN 
690 |a collaterals 
690 |a stroke 
690 |a cerebrovascular disease 
690 |a reperfusion therapy 
690 |a aetiology 
690 |a cardiovascular disease 
690 |a Medicine 
690 |a R 
690 |a Internal medicine 
690 |a RC31-1245 
690 |a Neurosciences. Biological psychiatry. Neuropsychiatry 
690 |a RC321-571 
690 |a Neurosciences. Biological psychiatry. Neuropsychiatry 
690 |a RC321-571 
655 7 |a article  |2 local 
786 0 |n Neurology International, Vol 13, Iss 4, Pp 608-621 (2021) 
787 0 |n https://www.mdpi.com/2035-8377/13/4/60 
787 0 |n https://doaj.org/toc/2035-8377 
856 4 1 |u https://doaj.org/article/cde4461b0fd44b92b7dc10acff1be82d  |z Connect to this object online.