Liebeskind DS, Cotsonis GA, Saver JL, Lynn MJ, Turan TN, Cloft HJ, et al. Symmetric CTA collaterals identify patients with slow-progressing stroke likely to benefit from late thrombectomy. Regenhardt RW, Gonzalez RG, He J, Lev MH, Singhal AB. 2018 Guidelines for the Early management of patients with acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Powers WJ, Rabinstein AA, Ackerson T, Adeoye OM, Bambakidis NC, Becker K, et al. 2015 American Heart Association/American Stroke Association focused update of the 2013 guidelines for the early management of patients with acute ischemic stroke regarding endovascular treatment: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Powers WJ, Derdeyn CP, Biller J, Coffey CS, Hoh BL, Jauch EC, et al. Guidelines for the early management of patients with acute ischemic stroke: 2019 update to the 2018 guidelines for the early management of acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Thrombectomy revascularization of large vessel occlusions in acute ischemic stroke 2 systemic thrombolysis for acute ischemic stroke TREVO 2: Solitaire with the intention for thrombectomy as primary endovascular treatment for acute ischemic stroke SYNTHESIS: Solitaire with the intention for thrombectomy SWIFT PRIME: best medical therapy in the treatment of acute stroke due to anterior circulation large vessel occlusion presenting within 8 h of symptom onset SWIFT: Randomized trial of revascularization with solitaire FR device vs. Mechanical retrieval and recanalization of stroke clots using embolectomy REVASCAT: Multicenter randomized clinical trial of endothelial treatment for acute ischemic stroke in the Netherlands MR RESCUE: Interventional management of stroke III MR CLEAN: Highly effective reperfusion evaluated in multiple endovascular stroke IMS III: Further randomized trials are needed to evaluate the risks and benefits of EVT in consideration of collateral status.ĭiffusion-weighted imaging or computerized tomography perfusion assessment with clinical mismatch in the triage of wake-up and late presenting strokes undergoing neurointervention with Trevo DEFUSE:ĭiffusion and perfusion imaging evaluation for understanding stroke evolution study ESCAPE:Įndovascular treatment for small core and anterior circulation proximal occlusion with emphasis on minimizing CT to recanalization times EXTEND-IA:Įxtending the time for thrombolysis in emergency neurological deficits–intra-arterial FLAIR:įluid attenuation inversion recovery HERMES: However, treatment decisions using information on patients’ collateral status have not progressed in clinical practice. The studies reviewed indicate that pretreatment collateral circulation is associated with both clinical and imaging outcomes after EVT in patients with acute ischemic stroke due to large vessel occlusion although most patients were already selected by other imaging or clinical criteria. Here, we systematically review the recent literature and summarized the outcomes of EVT according to the collateral status of patients with acute ischemic stroke caused by large vessel occlusion. Many post hoc studies, however, revealed that collateral status can help predict infarct growth, recanalization success, decreased hemorrhagic transformation after EVT, and extension of the therapeutic time window for revascularization. Although the collateral status has been studied and is known to modify imaging results and clinical course, it has not been commonly used for trials. Selection criteria of randomized control trials commonly include baseline infarct volume with or without penumbra evaluation. Endovascular treatment (EVT) using novel mechanical thrombectomy devices has been the gold standard for patients with acute ischemic stroke caused by large vessel occlusion.
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