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Objective <p>Collateral circulation is critical for mitigating ischemic damage in acute ischemic stroke (AIS). This dual-center retrospective cohort study enrolled 240 patients with AIS undergoing mechanical thrombectomy (MT) aimed to evaluate how carotid artery stenosis severity affects collateral flow dynamics, functional outcomes, and 90-day survival.</p> Results <p>Patients divided into mild stenosis group (<i>n</i> = 69), moderate stenosis group (<i>n</i> = 117) and severe stenosis and occlusion group (<i>n</i> = 54). Following MT, the ASITN/SIR and BATMAN scores showed a significant increase across all groups compared to pre-MT levels (<i>P</i> &lt; 0.05). However, a notable pattern emerged where both the pre-MT and post-MT scores in the severe stenosis and occlusion group were inferior to those observed in the moderate stenosis group and mild stenosis group (<i>P</i> &lt; 0.05). Multivariate logistic regression showed that patients with severe stenosis and occlusion (<i>OR</i> = 3.09, 95% <i>CI</i>:2.56–3.73, <i>p</i> &lt; 0.001), moderate stenosis (<i>OR</i> = 1.42, 95% <i>CI</i>: 1.13–1.78, <i>p</i> = 0.002), hypertension (<i>OR</i> = 3.36, 95% <i>CI</i>:1.47–7.63, <i>p</i> = 0.003) and T2DM (<i>OR</i> = 4.58, 95% <i>CI</i>:1.52–13.78, <i>p</i> = 0.006) were independent risk factors for poor collateral circulation. Kaplan-Meier curve analysis showed that the 90-day survival rate in the severe stenosis and occlusion group was lower than other groups (χ<sup>2</sup> = 26.716, <i>P</i> &lt; 0.001). These findings highlight the importance of preoperative stenosis evaluation to guide therapeutic strategies.</p>

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Effect of carotid artery stenosis on collateral flow status in patients with acute ischemic stroke after mechanical thrombectomy

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年7月1日

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  • Jing-Liang Su,
  • De-You Xue,
  • Xiang-Yang Wei,
  • Xin-Yu Yang

摘要

Objective

Collateral circulation is critical for mitigating ischemic damage in acute ischemic stroke (AIS). This dual-center retrospective cohort study enrolled 240 patients with AIS undergoing mechanical thrombectomy (MT) aimed to evaluate how carotid artery stenosis severity affects collateral flow dynamics, functional outcomes, and 90-day survival.

Results

Patients divided into mild stenosis group (n = 69), moderate stenosis group (n = 117) and severe stenosis and occlusion group (n = 54). Following MT, the ASITN/SIR and BATMAN scores showed a significant increase across all groups compared to pre-MT levels (P < 0.05). However, a notable pattern emerged where both the pre-MT and post-MT scores in the severe stenosis and occlusion group were inferior to those observed in the moderate stenosis group and mild stenosis group (P < 0.05). Multivariate logistic regression showed that patients with severe stenosis and occlusion (OR = 3.09, 95% CI:2.56–3.73, p < 0.001), moderate stenosis (OR = 1.42, 95% CI: 1.13–1.78, p = 0.002), hypertension (OR = 3.36, 95% CI:1.47–7.63, p = 0.003) and T2DM (OR = 4.58, 95% CI:1.52–13.78, p = 0.006) were independent risk factors for poor collateral circulation. Kaplan-Meier curve analysis showed that the 90-day survival rate in the severe stenosis and occlusion group was lower than other groups (χ2 = 26.716, P < 0.001). These findings highlight the importance of preoperative stenosis evaluation to guide therapeutic strategies.