Related Experiment Video
Updated: May 20, 2026
A Fibrin-Enriched and tPA-Sensitive Photothrombotic Stroke Model
Published on: June 4, 2021
Perfusion-weighted imaging-derived collateral flow index is a predictor of MCA M1 recanalization after i.v.
F Nicoli1, P Lafaye de Micheaux, N Girard
1Service d'Urgences Neuro-Vasculaires, Assistance Publique-Hôpitaux de Marseille (APHM), CHU de la Timone, Marseille, France. pr.f.nicoli@gmail.com
Background And Purpose:
Recent studies highlight the role of CC in preserving ischemic penumbra. Some authors suggested the quality of CC could also impact recanalization. The purpose of this study is to test this hypothesis in patients who were treated with i.v. thrombolysis for MCA-M1 occlusion.
Materials And Methods:
A normalized index derived from Tmax maps (MR-PWI) was defined to quantify the CC deficit (nCCD) in 64 patients with stroke who underwent i.v. thrombolysis. Correlations between nCCD and parameters that may be altered by CC quality were tested (baseline NIHSS, volume of diffusion abnormalities, modified Rankin Scale at 3 months). The correlation between baseline nCCD and MCA-M1 recanalization rate at 24 hours was tested.
Results:
The nCCD is significantly correlated with NIHSS and with lesional volume (Pearson correlation test, positive correlations, respectively, 0.40, 0.57; P = .00089, P = 8.7e-07). The nCCD also has a significant predictive value on the full recanalization at 24 hours that decreases as TTT increases (logistic regression, P = .021). Furthermore, among patients who were treated within 3 hours, nCCD and recanalization are significantly correlated (correlation ratio test, eta2 = 0.23, P = .0023): Patients who did not achieve full recanalization have significantly higher nCCD than fully recanalized patients (Mann-Whitney U test, P = .007). In addition, the probability of full recanalization decreases as the nCCD increases (P = .021). nCCD (OR 0.988, 95% CI 0.977-0.999, P = .042) and full recanalization at 24 hours (OR 4.539, 95% CI 1.252-16.456, P = .021) are independent predictors of functional independence at 3 months.
Conclusions:
The nCCD index is a predictor of full MCA-M1 recanalization in patients treated with i.v. thrombolysis.
Insights
The core-cap (CC) deficit index (nCCD) predicts successful recanalization in stroke patients receiving intravenous thrombolysis. Higher nCCD indicates a lower chance of full recanalization after MCA-M1 occlusion treatment.
Area of Science:
- Neuroscience
- Radiology
- Stroke Research
Background:
- Core-cap (CC) plays a role in preserving the ischemic penumbra.
- The quality of CC may influence recanalization rates in stroke patients.
- Investigating CC quality's impact on recanalization is crucial for treatment optimization.
Purpose of the Study:
- To test the hypothesis that CC quality impacts recanalization in MCA-M1 occlusion patients treated with i.v. thrombolysis.
- To quantify the core-cap deficit (nCCD) using a normalized index from Tmax maps (MR-PWI).
- To evaluate the correlation between nCCD and recanalization outcomes.
Main Methods:
- A cohort of 64 patients with stroke treated with i.v. thrombolysis for MCA-M1 occlusion was studied.
- A normalized index from Tmax maps (MR-PWI) was used to quantify the core-cap deficit (nCCD).
- Correlations between nCCD and clinical/imaging parameters (NIHSS, lesion volume, mRS) and recanalization rates were analyzed.
Main Results:
- nCCD significantly correlated with NIHSS and lesion volume (P < .001).
- nCCD predicted full recanalization at 24 hours, especially in patients treated within 3 hours (P = .0023).
- Higher nCCD was associated with lower recanalization rates and predicted functional independence at 3 months (P < .05).
Conclusions:
- The normalized core-cap deficit (nCCD) index is a significant predictor of full MCA-M1 recanalization.
- nCCD is an independent predictor of functional independence at 3 months post-thrombolysis.
- This index aids in assessing recanalization potential in stroke patients undergoing i.v. thrombolysis.
