Automated scoring of collaterals, blood pressure, and clinical outcome after endovascular treatment in patients with acute ischemic stroke and large-vessel occlusion

Introduction: We aimed to determine whether the degree of collateral circulation is associated with blood pressure at admission in acute ischemic stroke patients treated with endovascular treatment and to determine its prognostic value.

Methods: We evaluated patients with anterior large vessel occlusion treated with endovascular treatment in a single-center prospective registry. Automated and validated software (Brainomix Ltd., Oxford, UK) generated the collateral score (CS) from baseline single-phase CT angiography; CS was dichotomized as good (2–3) or poor (0–1). Ordinal logistic regression predicted CS categories, and the secondary outcome was the influence of automated CS on 3-month functional outcome (mRS 0–2).

Results: Among 101 patients (mean age 72.1 years, 56.4% women), admission systolic blood pressure (aOR per 10 mmHg 0.79) and higher baseline NIHSS (aOR 0.90) were associated with a worse CS. The OR of improving 1 point on the 3-month mRS was 1.63 favoring a better CS (p = 0.016).

Conclusion: Admission systolic blood pressure was inversely associated with automated CS on baseline CT angiography, and a good CS was associated with a favorable outcome.