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Peer-reviewedCC BY 4.0Journal of Clinical Medicine

Association of Multimodal Collateral Profiles with Outcomes After Large Core Thrombectomy

  • Rahul R. Karamchandani1
  • Liang Wang2
  • Gary Defilipp3
  • Jonathan D. Clemente3
  • Milan T. Quinn1
  • Jeremy B. Rhoten4
  • Dale Strong2
  • Andrew W. Asimos5
5 affiliations
  1. 1Department of Neurology, Wake Forest University School of Medicine, Advocate Health, Charlotte, NC 28203, USA
  2. 2Clinical Quality Analytics, Advocate Health, Charlotte, NC 28203, USA
  3. 3Department of Radiology, Charlotte Radiology, Wake Forest University School of Medicine, Advocate Health, Charlotte, NC 28203, USA
  4. 4Department of Neurology, Carolinas Medical Center, Advocate Health, Charlotte, NC 28203, USA
  5. 5Department of Emergency Medicine, Wake Forest University School of Medicine, Advocate Health, Charlotte, NC 28203, USA
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Abstract

Background/Objectives: Cerebral collateral circulation markers in large core thrombectomy and their impact on functional outcomes have not been extensively reported. Methods: We retrospectively analyzed health system medical records of large core (Alberta Stroke Program Early Computed Tomography Score <6 and/or computed tomography perfusion [CTP] cerebral blood flow <30% volume ≥50 milliliters [mL]) thrombectomy patients over a 19-month period. A good collateral profile (CCC+) was defined as the combination of computed tomography angiography Tan arterial score ≥2 and CTP cerebral blood volume index (CBVI) ≥0.8. A poor profile (CCC−) was defined as Tan <2 and CBVI <0.8. All others were categorized as having a mixed profile (CCC±). Multivariable Firth’s penalized logistic regression was used to identify factors independently associated with the primary outcome, 90-day modified Rankin Scale (mRS) 0–3. Results: 88 patients with median (interquartile range, IQR) age 65.5 (56.5–77.5) years and core volume 78 (55–116) mL were included. Forty-seven patients (53.4%) had poor collateral profiles, 31 (35.2%) were classified as CCC±, and 10 (11.4%) as CCC+. In the multivariable Firth’s penalized logistic regression model, CCC+ patients had higher odds of achieving a 90-day mRS of 0–3 compared with CCC− patients, though the difference was not statistically significant (odds ratio [OR] 1.117, 95% confidence interval [CI] 0.235–5.311, p = 0.889). No significant difference was observed between CCC± and CCC− patients (OR 0.869, 95% CI 0.293–2.577, p = 0.800). Glucose was the only factor independently associated with 90-day outcomes (OR 0.742, 95% CI 0.602–0.915, p = 0.005). Conclusions: No independent association was detected between favorable or mixed cerebral collateral circulation and 90-day mRS 0–3 after large core thrombectomy, though the study was underpowered for the CCC+ comparison. Presenting glucose may inform the likelihood of achieving independent ambulatory status at 90 days.

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Cite

BibTeXRIS
BibTeX
@article{karamchandani2026association,
  title = {{Association of Multimodal Collateral Profiles with Outcomes After Large Core Thrombectomy}},
  author = {Rahul R. Karamchandani and Liang Wang and Gary Defilipp and Jonathan D. Clemente and Milan T. Quinn and Jeremy B. Rhoten and Dale Strong and Andrew W. Asimos},
  journal = {Journal of Clinical Medicine},
  year = {2026},
  month = nov,
  doi = {10.3390/jcm15218730},
  url = {https://www.mdpi.com/2077-0383/15/21/8730},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Association of Multimodal Collateral Profiles with Outcomes After Large Core Thrombectomy
AU  - Rahul R. Karamchandani
AU  - Liang Wang
AU  - Gary Defilipp
AU  - Jonathan D. Clemente
AU  - Milan T. Quinn
AU  - Jeremy B. Rhoten
AU  - Dale Strong
AU  - Andrew W. Asimos
PY  - 2026
DA  - 2026/11/09
JO  - Journal of Clinical Medicine
DO  - 10.3390/jcm15218730
UR  - https://www.mdpi.com/2077-0383/15/21/8730
AB  - Background/Objectives: Cerebral collateral circulation markers in large core thrombectomy and their impact on functional outcomes have not been extensively reported. Methods: We retrospectively analyzed health system medical records of large core (Alberta Stroke Program Early Computed Tomography Score <6 and/or computed tomography perfusion [CTP] cerebral blood flow <30% volume ≥50 milliliters [mL]) thrombectomy patients over a 19-month period. A good collateral profile (CCC+) was defined as the combination of computed tomography angiography Tan arterial score ≥2 and CTP cerebral blood volume index (CBVI) ≥0.8. A poor profile (CCC−) was defined as Tan <2 and CBVI <0.8. All others were categorized as having a mixed profile (CCC±). Multivariable Firth’s penalized logistic regression was used to identify factors independently associated with the primary outcome, 90-day modified Rankin Scale (mRS) 0–3. Results: 88 patients with median (interquartile range, IQR) age 65.5 (56.5–77.5) years and core volume 78 (55–116) mL were included. Forty-seven patients (53.4%) had poor collateral profiles, 31 (35.2%) were classified as CCC±, and 10 (11.4%) as CCC+. In the multivariable Firth’s penalized logistic regression model, CCC+ patients had higher odds of achieving a 90-day mRS of 0–3 compared with CCC− patients, though the difference was not statistically significant (odds ratio [OR] 1.117, 95% confidence interval [CI] 0.235–5.311, p = 0.889). No significant difference was observed between CCC± and CCC− patients (OR 0.869, 95% CI 0.293–2.577, p = 0.800). Glucose was the only factor independently associated with 90-day outcomes (OR 0.742, 95% CI 0.602–0.915, p = 0.005). Conclusions: No independent association was detected between favorable or mixed cerebral collateral circulation and 90-day mRS 0–3 after large core thrombectomy, though the study was underpowered for the CCC+ comparison. Presenting glucose may inform the likelihood of achieving independent ambulatory status at 90 days.
SN  - 2077-0383
ER  -