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Angiographic Assessment of Pial Collaterals as a Prognostic Indicator Following Intra-arterial Thrombolysis for Acute Ischemic Stroke

Gregory A. Christoforidisa, Yousef Mohammadb, Dimitris Kehagiasa, Bindu Avutua and Andrew P. Slivkab

a Department of Radiology, Ohio State University Medical Center, Columbus, OH
b Department of Neurology, Ohio State University Medical Center, Columbus, OH



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  		FIG 1. Scoring of the anatomic extent of pial collateral blood flow from the ACA territory to the MCA territory during occlusion of the M1 segment. Scoring corresponds to the angiographically visible retrograde reconstitution of the MCA segments on the delayed venous phase. Each color is depicts the furthest extent of retrograde opacification depicted on anteroposterior cerebral angiograms for each pial collateral score.



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  		FIG 2. Anteroposterior (A and C) and lateral (B and C) images from a left internal carotid artery angiogram obtained during the early (A and B) and delayed angiographic phases (C and D) in a patient with acute ischemic stroke due to occlusion at the M1 segment (arrow). Note the retrograde opacification of the MCA branches via pial collateral vessels extending from the ACA (arrowheads). Because there is reverse opacification of the MCA extending to the distal M1 segment, a pial collateral formation score of 1 was assigned.





Copyright © 2009 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X