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Purpose: Diabetes is associated with vascular dysfunction potentially impairing collateral recruitment in acute ischemic stroke. This retrospective study aimed at analyzing the impact of diabetes on collateralization assessed on dynamic CTA., Methods: Collaterals were retrospectively assessed on CT perfusion-derived dynamic CTA according to the mCTA score by Menon in a cohort of patients with an acute occlusion of the M1 segment or carotid T. The extent of collateral circulation was related to the history of diabetes and to admission blood glucose and HbA1c levels., Results: Two hundred thirty-nine patients were included. The mCTA collateral score was similar in patients with diabetes (median 3, interquartile range 3-4) and without diabetes (median 4, interquartile range 3-4) (P = 0.823). Diabetes was similarly frequent in patients with good (18.8%), intermediate (16.1%), and poor collaterals (16.0%) (P = 0.355). HbA1c was non-significantly higher in patients with poor collaterals (6.3 ± 1.5) compared to patients with intermediate (6.0 ± 0.9) and good collaterals (5.8 ± 0.9) (P = 0.061). Blood glucose levels were significantly higher in patients with poor compared to good collaterals (mean 141.6 vs. 121.8 mg/dl, P = 0.045). However, there was no significant difference between good and intermediate collaterals (mean 121.8 vs. 129.5 mg/dl, P = 0.161) as well as between intermediate and poor collaterals (129.5 vs. 141.6 mg/dl, P = 0.161)., Conclusion: There was no statistically significant difference among patients with good, intermediate, and poor collaterals regarding the presence of diabetes or HbA1c level on admission. However, stroke patients with poor collaterals tend to have higher blood glucose and HbA1c levels., (© 2021. The Author(s).)

Background and Purpose: Several collateral scores have been published for stroke in the middle cerebral artery territory, each considering different aspects of cerebral collateralization. Currently, there is no gold standard in CT-based collateral assessment. The aim of this retrospective study was to compare five collateral scores and determine whether they are able to predict clinical outcome after thrombectomy as standalone parameters., Methods: Inclusion criteria were M1 occlusion, premorbid modified Rankin scale (mRS) of 0-3, treatment with endovascular thrombectomy and groin puncture within 12 h after stroke onset. The Maas et al., Miteff et al., Tan et al., ASITN/SIR and mCTA collateral scores were retrospectively assessed in multiphase CTA images and correlated with 90-day mRS (90d-mRS) scores. Good outcome was defined as 90d-mRS 0-2 or unchanged to premorbid mRS., Results: In total, 108 patients were included of which 39.8% achieved a good outcome. The area under the curve (AUC) values of receiver operating characteristic (ROC) curve analysis for Maas et al., Miteff et al., Tan et al., ASITN/SIR and mCTA scores were 0.60 (0.51-0.70), 0.60 (0.52-0.68), 0.61 (0.51-0.70), 0.59 (0.49-0.70) and 0.61 (0.50-0.71), respectively. The correlation between 90d-mRS and Maas (r = -0.16, P = 0.091), Miteff (r = -0.25, P = 0.009), Tan (r = -0.26, P = 0.007), ASITN/SIR (r = -0.21, P = 0.030) and mCTA (r = -0.22, P = 0.021) scores was poor., Conclusion: Although collaterals are known to correlate with clinical outcome, none of the analyzed collateral scores sufficiently predicted outcome as a standalone parameter.