Journal article
Collateral status and outcomes in ICAS-LVO: insights from the RESCUE-ICAS registry
Neuroradiology
08/05/2026
DOI: 10.1007/s00234-026-04125-2
PMID: 42554836
Abstract
Collateral circulation influences outcomes in large-vessel occlusion (LVO) stroke, yet its modifying effect on endovascular therapy for intracranial atherosclerosis-related LVO (ICAS-LVO) remains uncertain. This study evaluated whether collateral status alters the association between stent-assisted thrombectomy and outcomes in anterior-circulation ICAS-LVO.
An analysis was performed on 271 anterior-circulation ICAS-LVO patients from the RESCUE-ICAS registry. Collateral status was graded using the Tan collateral score (0-1 = poor, 2-3 = good). Patients were treated with mechanical thrombectomy (MT) alone or MT with adjunctive stenting. The primary outcome was functional independence (modified Rankin Scale [mRS] = 0-2) at 90 days. Secondary outcomes included successful reperfusion (mTICI≥2b), symptomatic intracranial hemorrhage (sICH), and mortality.
Among 271 patients, 172 (63.5% ) had good, and 99 (36.5%) had poor collaterals. In adjusted interaction models, stenting improved 90-day functional independence (aOR 3.22, p = 0.030) without significant stent-collateral interaction (p = 0.876). No significant interactions were observed for mortality (p = 0.847) or sICH (p = 0.909). A significant adjusted interaction was present for final recanalization (interaction OR 8.35, p = 0.044).
In anterior-circulation ICAS-LVO, adjunctive stenting was associated with improved functional outcomes across collateral strata, with collateral status showing some modification of the stent effect on angiographic success.
Details
- Title: Subtitle
- Collateral status and outcomes in ICAS-LVO: insights from the RESCUE-ICAS registry
- Creators
- Mustafa Ismail - Medical University of South CarolinaAhmad Abu Qdais - Medical University of South CarolinaEyad Almallouhi - Sarasota Memorial HospitalAdam De Havenon - Yale UniversityBasem Zaino - Medical University of South CarolinaVioliza Inoa - University of Tennessee Health Science CenterFrancesco Capasso - Azienda Ospedaliero-Universitaria CareggiMichael Nahhas - The University of Texas Health Science Center at HoustonRobert M Starke - University of MiamiIsabel Fragata - Hospital de São JoséMatthew T Bender - University of Rochester MedicineKrisztina Moldovan - Brown UniversityIlko Maier - University of GöttingenJonathan A Grossberg - Emory UniversityPascal Jabbour - Thomas Jefferson UniversityEdgar A Samaniego - University of IowaJan-Karl Burkhardt - University of PennsylvaniaMohamad Abdalkader - Boston UniversityElizabeth Blalock - Medical University of South CarolinaAmeer E Hassan - Valley Baptist Medical CenterDavid Altschul - Albert Einstein College of MedicineJustin Mascitelli - The University of Texas at San Antonio Health Science CenterRobert W Regenhardt - Harvard UniversityStacey Wolfe - Wake Forest UniversityMohamad Ezzeldin - Lone Star College KingwoodKaustubh Limaye - Indiana University – Purdue University IndianapolisHosam Al Jehani - Montreal Neurological Institute and HospitalMuhammad H Niazi - WellSpan HealthNitin Goyal - University of Tennessee Health Science CenterMouhammad Jumaa - University of ToledoRamesh Grandhi - University of UtahThanh N Nguyen - Boston UniversityShadi Yaghi - Brown UniversitySami Al Kasab - Medical University of South Carolina
- Resource Type
- Journal article
- Publication Details
- Neuroradiology
- DOI
- 10.1007/s00234-026-04125-2
- PMID
- 42554836
- NLM abbreviation
- Neuroradiology
- ISSN
- 1432-1920
- eISSN
- 1432-1920
- Publisher
- Springer Nature
- Grant note
- Medical University of South Carolina
Open access funding provided by the Carolinas Consortium.
- Language
- English
- Electronic publication date
- 08/05/2026
- Academic Unit
- Neurology; Radiology; Iowa Neuroscience Institute; Neurosurgery
- Record Identifier
- 9985217816402771
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