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Wiegers EJA, Mulder MJHL, Jansen IGH, Venema E, Compagne KCJ, Berkhemer OA, Emmer BJ, Marquering HA, van Es ACGM, Sprengers ME, van Zwam WH, van Oostenbrugge RJ, Roos YBWEM, Majoie CBLM, Roozenbeek B, Lingsma HF, Dippel DWJ, van der Lugt A. Clinical and Imaging Determinants of Collateral Status in Patients With Acute Ischemic Stroke in MR CLEAN Trial and Registry. Stroke 2020; 51:1493-1502. [PMID: 32279619 DOI: 10.1161/strokeaha.119.027483] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Background and Purpose- Collateral circulation status at baseline is associated with functional outcome after ischemic stroke and effect of endovascular treatment. We aimed to identify clinical and imaging determinants that are associated with collateral grade on baseline computed tomography angiography in patients with acute ischemic stroke due to an anterior circulation large vessel occlusion. Methods- Patients included in the MR CLEAN trial (Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands; n=500) and MR CLEAN Registry (n=1488) were studied. Collateral status on baseline computed tomography angiography was scored from 0 (absent) to 3 (good). Multivariable ordinal logistic regression analyses were used to test the association of selected determinants with collateral status. Results- In total, 1988 patients were analyzed. Distribution of the collateral status was as follows: absent (7%, n=123), poor (32%, n=596), moderate (39%, n=735), and good (23%, n=422). Associations for a poor collateral status in a multivariable model existed for age (adjusted common odds ratio, 0.92 per 10 years [95% CI, 0.886-0.98]), male (adjusted common odds ratio, 0.64 [95% CI, 0.53-0.76]), blood glucose level (adjusted common odds ratio, 0.97 [95% CI, 0.95-1.00]), and occlusion of the intracranial segment of the internal carotid artery with occlusion of the terminus (adjusted common odds ratio 0.50 [95% CI, 0.41-0.61]). In contrast to previous studies, we did not find an association between cardiovascular risk factors and collateral status. Conclusions- Older age, male sex, high glucose levels, and intracranial internal carotid artery with occlusion of the terminus occlusions are associated with poor computed tomography angiography collateral grades in patients with acute ischemic stroke eligible for endovascular treatment.
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Affiliation(s)
- Eveline J A Wiegers
- From the Department of Public Health (E.J.A.W., E.V., H.F.L.), Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Maxim J H L Mulder
- Department of Neurology (M.J.H.L.M., E.V., K.C.J.C., O.A.B., B.R., D.W.J.D.), Erasmus University Medical Center, Rotterdam, the Netherlands.,Department of Radiology and Nuclear Medicine (M.J.H.L.M., K.C.J.C., O.A.B., A.C.G.M.v.E., B.R., A.v.d.L.), Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Ivo G H Jansen
- Department of Radiology and Nuclear Medicine (I.G.H.J., B.J.E., H.A.M., M.E.S., C.B.L.M.M.), Amsterdam UMC, location AMC, the Netherlands
| | - Esmee Venema
- From the Department of Public Health (E.J.A.W., E.V., H.F.L.), Erasmus University Medical Center, Rotterdam, the Netherlands.,Department of Neurology (M.J.H.L.M., E.V., K.C.J.C., O.A.B., B.R., D.W.J.D.), Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Kars C J Compagne
- Department of Neurology (M.J.H.L.M., E.V., K.C.J.C., O.A.B., B.R., D.W.J.D.), Erasmus University Medical Center, Rotterdam, the Netherlands.,Department of Radiology and Nuclear Medicine (M.J.H.L.M., K.C.J.C., O.A.B., A.C.G.M.v.E., B.R., A.v.d.L.), Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Olvert A Berkhemer
- Department of Neurology (M.J.H.L.M., E.V., K.C.J.C., O.A.B., B.R., D.W.J.D.), Erasmus University Medical Center, Rotterdam, the Netherlands.,Department of Radiology and Nuclear Medicine (M.J.H.L.M., K.C.J.C., O.A.B., A.C.G.M.v.E., B.R., A.v.d.L.), Erasmus University Medical Center, Rotterdam, the Netherlands.,Cardiovascular Research Institute Maastricht, the Netherlands (O.A.B., W.H.v.Z., R.J.v.O.)
| | - Bart J Emmer
- Department of Radiology and Nuclear Medicine (I.G.H.J., B.J.E., H.A.M., M.E.S., C.B.L.M.M.), Amsterdam UMC, location AMC, the Netherlands
| | - Henk A Marquering
- Department of Radiology and Nuclear Medicine (I.G.H.J., B.J.E., H.A.M., M.E.S., C.B.L.M.M.), Amsterdam UMC, location AMC, the Netherlands.,Department of Biomedical Engineering and Physics (H.A.M.), Amsterdam UMC, location AMC, the Netherlands
| | - Adriaan C G M van Es
- Department of Radiology and Nuclear Medicine (M.J.H.L.M., K.C.J.C., O.A.B., A.C.G.M.v.E., B.R., A.v.d.L.), Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Marieke E Sprengers
- Department of Radiology and Nuclear Medicine (I.G.H.J., B.J.E., H.A.M., M.E.S., C.B.L.M.M.), Amsterdam UMC, location AMC, the Netherlands
| | - Wim H van Zwam
- Cardiovascular Research Institute Maastricht, the Netherlands (O.A.B., W.H.v.Z., R.J.v.O.).,Department of Radiology (W.H.v.Z.), Maastricht University Medical Center, the Netherlands
| | - Robert J van Oostenbrugge
- Cardiovascular Research Institute Maastricht, the Netherlands (O.A.B., W.H.v.Z., R.J.v.O.).,Department of Neurology (R.J.v.O.), Maastricht University Medical Center, the Netherlands
| | - Yvo B W E M Roos
- Department of Neurology, Academic Medical Center, Amsterdam, the Netherlands (Y.B.W.E.M.R.)
| | - Charles B L M Majoie
- Department of Radiology and Nuclear Medicine (I.G.H.J., B.J.E., H.A.M., M.E.S., C.B.L.M.M.), Amsterdam UMC, location AMC, the Netherlands
| | - Bob Roozenbeek
- Department of Neurology (M.J.H.L.M., E.V., K.C.J.C., O.A.B., B.R., D.W.J.D.), Erasmus University Medical Center, Rotterdam, the Netherlands.,Department of Radiology and Nuclear Medicine (M.J.H.L.M., K.C.J.C., O.A.B., A.C.G.M.v.E., B.R., A.v.d.L.), Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Hester F Lingsma
- From the Department of Public Health (E.J.A.W., E.V., H.F.L.), Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Diederik W J Dippel
- Department of Neurology (M.J.H.L.M., E.V., K.C.J.C., O.A.B., B.R., D.W.J.D.), Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Aad van der Lugt
- Department of Radiology and Nuclear Medicine (M.J.H.L.M., K.C.J.C., O.A.B., A.C.G.M.v.E., B.R., A.v.d.L.), Erasmus University Medical Center, Rotterdam, the Netherlands
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Bersano A, Bedini G, Nava S, Acerbi F, Sebastiano DR, Binelli S, Franceschetti S, Faragò G, Grisoli M, Gioppo A, Ferroli P, Bruzzone MG, Riva D, Ciceri E, Pantaleoni C, Saletti V, Esposito S, Nardocci N, Zibordi F, Caputi L, Marzoli SB, Zedde ML, Pavanello M, Raso A, Capra V, Pantoni L, Sarti C, Pezzini A, Caria F, Dell' Acqua ML, Zini A, Baracchini C, Farina F, Sanguigni S, De Lodovici ML, Bono G, Capone F, Di Lazzaro V, Lanfranconi S, Toscano M, Di Piero V, Sacco S, Carolei A, Toni D, Paciaroni M, Caso V, Perrone P, Calloni MV, Romani A, Cenzato M, Fratianni A, Ciusani E, Prontera P, Lasserve ET, Blecharz K, Vajkoczy P, Parati EA. GEN-O-MA project: an Italian network studying clinical course and pathogenic pathways of moyamoya disease-study protocol and preliminary results. Neurol Sci 2019; 40:561-570. [PMID: 30604336 DOI: 10.1007/s10072-018-3664-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 11/28/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND GENetics of mOyaMoyA (GEN-O-MA) project is a multicenter observational study implemented in Italy aimed at creating a network of centers involved in moyamoya angiopathy (MA) care and research and at collecting a large series and bio-repository of MA patients, finally aimed at describing the disease phenotype and clinical course as well as at identifying biological or cellular markers for disease progression. The present paper resumes the most important study methodological issues and preliminary results. METHODS Nineteen centers are participating to the study. Patients with both bilateral and unilateral radiologically defined MA are included in the study. For each patient, detailed demographic and clinical as well as neuroimaging data are being collected. When available, biological samples (blood, DNA, CSF, middle cerebral artery samples) are being also collected for biological and cellular studies. RESULTS Ninety-eight patients (age of onset mean ± SD 35.5 ± 19.6 years; 68.4% females) have been collected so far. 65.3% of patients presented ischemic (50%) and haemorrhagic (15.3%) stroke. A higher female predominance concomitantly with a similar age of onset and clinical features to what was reported in previous studies on Western patients has been confirmed. CONCLUSION An accurate and detailed clinical and neuroimaging classification represents the best strategy to provide the characterization of the disease phenotype and clinical course. The collection of a large number of biological samples will permit the identification of biological markers and genetic factors associated with the disease susceptibility in Italy.
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Affiliation(s)
- Anna Bersano
- Cerebrovascular Unit, Neurological Institute "C. Besta" IRCCS Foundation, Milan, Italy.
| | - Gloria Bedini
- Laboratory of Cellular Neurobiology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Sara Nava
- Laboratory of Cellular Neurobiology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Francesco Acerbi
- Neurosurgical Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Davide Rossi Sebastiano
- Neurophysiopathology Department and Epilepsy Centre, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Simona Binelli
- Neurophysiopathology Department and Epilepsy Centre, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Silvana Franceschetti
- Neurophysiopathology Department and Epilepsy Centre, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Giuseppe Faragò
- Diagnostic Imaging Department & Interventional Neuroradiology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Marina Grisoli
- Neuroradiological Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Andrea Gioppo
- Diagnostic Imaging Department & Interventional Neuroradiology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Paolo Ferroli
- Neurosurgical Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Maria Grazia Bruzzone
- Neuroradiological Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Daria Riva
- Developmental Neurology Division, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Elisa Ciceri
- Neuroradiological Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Chiara Pantaleoni
- Developmental Neurology Division, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Veronica Saletti
- Developmental Neurology Division, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Silvia Esposito
- Developmental Neurology Division, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Nardo Nardocci
- Department of Child Neurology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Federica Zibordi
- Department of Child Neurology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Luigi Caputi
- Cerebrovascular Unit, Neurological Institute "C. Besta" IRCCS Foundation, Milan, Italy
| | | | - Maria Luisa Zedde
- Neurology Unit, Stroke Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | | | | | - Valeria Capra
- Neurosurgery Unit, Istituto Giannina Gaslini, Genoa, Italy
| | - Leonardo Pantoni
- L.Sacco Department of Biomedical and Clinical Science, University of Milan, Milan, Italy
| | - Cristina Sarti
- NEUROFARBA Department Neuroscience Section, University of Florence, Florence, Italy
| | - Alessandro Pezzini
- Department of Clinical and Experimental Sciences, Neurology Clinic, University of Brescia, Brescia, Italy
| | - Filomena Caria
- Department of Clinical and Experimental Sciences, Neurology Clinic, University of Brescia, Brescia, Italy
| | - Maria Luisa Dell' Acqua
- Stroke Unit, Nuovo Ospedale Civile S Agostino Estense, University Hospital of Modena, Modena, Italy
| | - Andrea Zini
- Stroke Unit, Nuovo Ospedale Civile S Agostino Estense, University Hospital of Modena, Modena, Italy
| | - Claudio Baracchini
- Stroke Unit and Neurosonology Laboratory, Department of Neurological Sciences, University of Padua School of Medicine, Padua, Italy
| | - Filippo Farina
- Stroke Unit and Neurosonology Laboratory, Department of Neurological Sciences, University of Padua School of Medicine, Padua, Italy
| | - Sandro Sanguigni
- Department of Neurology, General Hospital Madonna del Soccorso, San Benedetto del Tronto, Italy
| | | | - Giorgio Bono
- Stroke Unit Circolo Hospital and Macchi Foundation, Varese Hospital, Varese, Italy
| | - Fioravanti Capone
- Unit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo 200, 00128, Rome, Italy
| | - Vincenzo Di Lazzaro
- Unit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo 200, 00128, Rome, Italy
| | - Silvia Lanfranconi
- Department of Neuroscience and Sensory Organs, Neurology Unit, Maggiore Policlinico Hospital Foundation IRCCS Ca' Granda, Milan, Italy
| | - Massimiliano Toscano
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | - Vittorio Di Piero
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | - Simona Sacco
- Department of Neurology, Avezzano Hospital, University of L'Aquila, L'Aquila, Italy
| | - Antonio Carolei
- Department of Neurology, Avezzano Hospital, University of L'Aquila, L'Aquila, Italy
| | - Danilo Toni
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | - Maurizio Paciaroni
- Stroke Unit and Division of Cardiovascular Medicine, University of Perugia, Perugia, Italy
| | - Valeria Caso
- Stroke Unit and Division of Cardiovascular Medicine, University of Perugia, Perugia, Italy
| | - Patrizia Perrone
- Stroke Unit Legnano Hospital ASST Ovest Milanese, Legnano, Italy
| | | | - Alfredo Romani
- IRCCS Foundation C. Mondino Neurological Institute, Pavia, Italy
| | - Marco Cenzato
- Department of Neurosurgery, Niguarda Cà Granda Hospital, Milan, Italy
| | - Alessia Fratianni
- Department of Neurosurgery, Niguarda Cà Granda Hospital, Milan, Italy
| | - Emilio Ciusani
- Laboratory of Clinical Investigations, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Paolo Prontera
- Neonatology Unit and Prenatal Diagnosis (P.P.), Medical Genetic Unit, Ospedale S. Maria della Misericordia, Perugia, Italy
| | - Elisabeth Tournier Lasserve
- Inserm UMR-S1161, Génétique et Physiopathologie des Maladies Cérébro-vasculaires, Université Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - Kinga Blecharz
- Department of Neurosurgery, Charite Universitätsmedizin, Berlin, Germany
| | - Peter Vajkoczy
- Department of Neurosurgery, Charite Universitätsmedizin, Berlin, Germany
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