Good collateral circulation predicts favorable outcomes in intravenous thrombolysis: a systematic review and meta‐analysis

Abstract

The present study has demonstrated the prognostic value of baseline collateral circulation for outcomes of acute ischaemic stroke patients receiving intravenous reperfusion therapies, studied with different time windows of up to 7 h after ictus for IVT therapy.

Cerebral collateral circulation and acute ischaemic stroke

“…However, the study was not able to address the issue of whether the improved outcomes associated with superior collateral circulation status are the result of any increased efficacy of thrombolysis therapy or simply attributable to more favourable outcomes after AIS in general, irrespective of IVT therapy. Indeed, the study did not demonstrate an increased rate of reperfusion or recanalization to be associated with a higher pre‐treatment collateral circulation grade . Furthermore, because the study only considers patients treated with IVT, the lack of a control arm means that it is not possible to assess the risk−benefit poise of performing thrombolysis in different scenarios.…”

“…perform a systematic review and meta‐analysis investigating the effect of collateral circulation on outcomes after AIS in patients receiving intravenous thrombolysis (IVT) . Their findings demonstrate that good pre‐treatment collateral circulation is associated with superior functional outcome at 3 or 6 months . In addition, good collateral circulation is also shown to be associated with reduced risk of symptomatic intracranial haemorrhage and improved early neurological improvement .…”

“…The degree of such collateral blood supply varies amongst individuals suffering acute ischaemic stroke (AIS) and can influence outcomes [2]. In this issue of the European Journal of Neurology, Leng et al perform a systematic review and meta-analysis investigating the effect of collateral circulation on outcomes after AIS in patients receiving intravenous thrombolysis (IVT) [3]. Their findings demonstrate that good pre-treatment collateral circulation is associated with superior functional outcome at 3 or 6 months [3].…”

“…In this issue of the European Journal of Neurology, Leng et al perform a systematic review and meta-analysis investigating the effect of collateral circulation on outcomes after AIS in patients receiving intravenous thrombolysis (IVT) [3]. Their findings demonstrate that good pre-treatment collateral circulation is associated with superior functional outcome at 3 or 6 months [3]. In addition, good collateral circulation is also shown to be associated with reduced risk of symptomatic intracranial haemorrhage and improved early neurological improvement [3].However, the study was not able to address the issue of whether the improved outcomes associated with superior collateral circulation status are the result of any increased efficacy of thrombolysis therapy or simply attributable to more favourable outcomes after AIS in general, irrespective of IVT therapy.…”

Advances and insights into neurological practice 2016−17

“…Stroke represents the largest proportion of papers published, including those on pathophysiology , acute stroke management and the outcome of patients who have suffered stroke . Stroke is a worldwide problem, but its prevalence varies and may reflect both the genetic and environmental contributions to stroke, both in turn reflecting the known risk factors for stroke.…”