BACKGROUND AND PURPOSE: Patients with stroke etiology of large-artery atherosclerosis were thought to have better collateral circulation compared with patients with other stroke etiologies. We aimed to investigate the association between stroke etiology and collateral circulation with a new quantitative collateral assessment method. MATERIALS AND METHODS:This retrospective study reviewed data from consecutive patients with proximal anterior artery occlusion who underwent CTP before reperfusion therapy. CBF maps were derived from CTP. A new indicator, maximum CBF of collateral vessels within the Sylvian fissure (cCBF max ), was applied to quantitatively assess the collateral status. The relationship between collateral status and stroke etiology was investigated.RESULTS: A total of 296 patients were finally analyzed. The median cCBF max was significantly higher in patients with large-artery atherosclerosis than in those without it (92 [interquartile range, 65-123] mL/100 g/min versus 62 [interquartile range, 46-82] mL/100 g/min; P , .001). Multivariable analysis revealed that a higher cCBF max score was independently associated with large-artery atherosclerosis etiology (OR, 1.010; 95% CI, 1.002-1.018; P ¼ .017) after adjustment. The area under the curve, sensitivity, and specificity of the final model in predicting the etiology of large-artery atherosclerosis were 0.870, 89.7%, and 75.2%, respectively.CONCLUSIONS: Patients with large-artery atherosclerosis had a more adequate collateral perfusion supply with the new quantitative collateral assessment. The new quantitative collateral measurement might contribute to the prediction of stroke etiology in the acute clinical scenario for patients with acute ischemic stroke.ABBREVIATIONS: AIS ¼ acute ischemic stroke; AUC ¼ area under the curve; cCBF max ¼ maximum CBF of collateral vessels within the Sylvian fissure; CE ¼ cardioembolism; IQR ¼ interquartile range; LAA ¼ large-artery atherosclerosis; ROC ¼ receiver operating characteristic I ntracranial large-artery occlusion is a common cause of acute ischemic stroke (AIS), which often leads to a poor prognosis. 1,2 Endovascular therapy could greatly improve the recanalization rate of the occluded arteries and has been recommended as a standard therapy for patients with acute proximal large-artery occlusion. 3 The success of endovascular therapy was influenced by the stroke etiology. 4,5 The secondary prevention strategies would also depend on stroke etiologies. Therefore, prediction of stroke etiology might provide potentially pivotal information for neurologists and neurointerventionists to guide management in the acute clinical scenario and enable early initiation of appropriate secondary prevention.Collateral circulation in patients with AIS can maintain perfusion and may influence the timing of ischemic brain tissue-that is, collateral circulation contributes to improving the prognosis of patients with ischemic stroke. Several clinical trials such as the Endovascular Treatment for Small Core and Anterior Circulation ...
Core materials with high strength and excellent collapsibility are important for the manufacture of hollow composite structure castings. In this work, a novel technology to fabricate water-soluble Na2SO4-NaCl based salt cores with high strength and low cost by layered extrusion forming (LEF) was reported. The water-soluble Na2SO4 and NaCl powder were used as the matrix materials, and the bauxite powder was used as the reinforcing material. The effects of bauxite powder content and liquid phase sintering parameters on properties of the salt cores were studied. The results show that the salt-based slurry exhibits shear thinning property within the studied bauxite powder contents. When the content of bauxite powder was 20 wt.% and the sintering was at 630 ℃/30 min, the obtained salt cores show an optimal comprehensive performance, with the bending strength, linear shrinkage, water-solubility rate and moisture rate of 24.43 MPa, 6.3%, 207.6 (g/min·m2), and 0.29%, respectively. The complex water-soluble salt core samples prepared under the optimal parameters display high-strength and well-shaped morphology.
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