Anterior Borderzone Angle for Hemodynamic Collateral Metric in Patients with Symptomatic Middle Cerebral Artery Stenosis

摘要

Background and Aims: We aimed to introduce a parameter of anterior borderzone angle (ABZA) to quantitatively evaluate the ACA-MCA leptomeningeal collaterals for middle cerebral artery stenosis (MCAS). Methods: Two hundred seventy-five patients with 50–100 MCAS and 100 controls were included. The 95 reference range of ABZA was obtained from the controls. ABZA_(trans)was defined as “ABZA/the 95 upper limit.” Relationships between ABZA and MCAS, -ABZA_(trans)and the TICI grade, the American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology (ASITN/SIR) collateral grade were analyzed. An ABZA grade model for the ACA leptomeningeal collaterals was tentatively developed. Results: The 95 reference range of ABZA was 0.0o–23.0o. ABZA was significantly associated with MCAS by a function of the fourth power (R~(2)?= 0.723, p? 0.001), and could predict hemodynamic MCAS (≥70) with an AUC of 0.928 (95 CI 0.903–0.953). ABZA_(trans)was negatively correlated with the TICI grade (rho ?= –0.752, p? 0.001) and positively with the ASITN/SIR grade (rho ?= 0.921, p? 0.001). The ABZA grade was created by rounding -ABZA_(trans)to a nearest integer, and was closely associated with the ASITN/SIR grade (rho?= 0.894, p? 0.001). Conclusions: ABZA can be used as a hemodynamic parameter to quantitatively evaluate ACA leptomeningeal collaterals.