Article Figures & Data
Tables
Modality Different Assessment Methods No. of Publications Studies with Inter-/Intraobserver Agreement Assessed Angiography 41 58 26,14,40 CT 7 12 55,64,69,71,72 MR imaging 9 13 0 TCD 6 7 0 Description Grading Author (No.) Acute (<24 hr from Symptom Onset)/Non-Acute Reliability Assessed? Prognostic Significance of Good Collateral Flow Grade in Acute Stroke Extent of anterograde and retrograde vessel filling 0–3 Brandt7 (20) Acute No Beneficial7,8 Arnold et al8 (40) No. and rapidity of collateral vessel filling 0–2 von Kummer9 (53) Acute No Beneficial No. and rapidity of collateral vessel filling N/A Bozzao et al10 (36) Acute No NS10 Bozzao et al11 (36) NS11, beneficial63 Toni et al63 (80) Filling extent of main and distal vessels via collaterals 0–3 Wu et al13 (51) Nonacute No N/A Reconstitution of vessel relative to occlusion 1–5 Christoforidis et al6 (104) Acute Yes, κ = 0.816,14 Beneficial6,14 Christoforidis et al14 (53) Retrograde MCA flow to insula Present, absent, indeterminate Derdeyn et al15 (117) Nonacute No N/A Rapidity and extent of retrograde collateral flow 0–4 Bang et al4 (44) Acute No Beneficial4,17,20 Higashida et al16 (0)a N/A16 Bang et al17 (119) No effect18 Ovbiagele et al18 (95) NS19,21–23 Sanossian et al19 (74) Liebeskind20 (120) Liebeskind21 (120) Liebeskind22 (50) Liebeskind23 (66) Flow extent across cortical surface N/A Powers et al24 (19) Nonacute No N/A Visual inspection N/A Klijn et al25 (76) Nonacute No N/A Delayed contrast washout N/A Essig et al26 (30) Nonacute No N/A Visualization of slow flow N/A Kamran et al27 (8) Acute No NS Visualization of flow pattern Grade 4 = leptomeningeal flow Ozgur et al28 (27) Nonacute No N/A Cortical branches from contralateral ACA/PCA N/A Rutgers et al29 (112) Nonacute No N/A Visualization of pial vessels N/A Zappe et al30 (86) Unclear No NS Visualization of anastomoses from adjacent vascular territories N/A Noguchi et al31 (5) Acute No NS Visualization of arteriogram N/A Grubb et al32 (81) Nonacute No N/A Cortical arteries from PCA N/A Fukuyama et al33 (3) Nonacute No N/A No. and rapidity of vessel filling 0–2 Lee et al34 (8) Acute No NS Distal MCA branches filling through ACA or PCA N/A Kim et al35 (51) Acute No NS Retrograde vessel filling N/A Kinoshita et al36 (10) Unclear No NS Cortical branches from PCA to MCA N/A van Laar et al37 (23) Nonacute No N/A Retrograde filling of MCA branches N/A Yamauchi et al38 (42) Nonacute No N/A Extent and no. of vessels filling via collateral flow Absent, mild, or prominent Uemura et al39 (25) Combination No NS Combination of occlusion site and extent of collateral flow 0–5 Qureshi40 (15) Acute Yes, κ = 0.7340 Beneficial40–42 Mohammad et al41 (57) Mohammad et al42 (55) Extent of retrograde flow in MCA Good, poor Kucinski et al43 (111) Acute No Beneficial Gasparotti et al44 (27) Capillary blush in MCA Grade 4 = leptomeningeal flow Russell et al45 (14) Nonacute No N/A MCA/PCA filling from posterior circulation N/A Bischopps et al46 (68) Nonacute No N/A Opacification of basilar artery by collaterals Distal vs distal and proximal Cross et al47 (24) Acute No Beneficial Cortical branches filling MCA/ACA from PCA N/A Bokkers et al48 (17) Nonacute No N/A Pial collateral flow from ACA and PCA N/A Derdeyn et al49 (10) Nonacute No N/A Flow via anastomotic channels on brain surface N/A Smith et al50 (18) Nonacute No N/A Collateral flow assessment based on ASPECTS (13 areas) 0–3 in corresponding anatomic locations Chng et al51 (18) Nonacute No N/A No. and rapidity of vessel filling from ACA Good or scarce von Kummer et al52 (77) Acute No No effect No. and rapidity of vessel filling from ACA and PCA 0–2 von Kummer et al53 (32) Acute No Beneficial Filling extent of at risk territory 1–3 Roberts et al54 (180) Acute No Beneficial Collateral flow assessment based on ASPECTS (15 areas) 0–3 in corresponding anatomic locations Kim et al55 (44) Acute No Beneficial MCA branch filling in early venous phase Good, moderate, poor Ringelstein et al56 (34) Acute No Beneficial Retrograde arterioles visualized in capillary phase N/A Weidner et al57 (4) Unclear No NS57 Presence of superficial PCA/ACA cortical branches N/A Hoffmeijer et al58 (70) Nonacute No N/A Extent of leptomeningeal anastomoses in occluded territory Poor, good Arnold et al59 (98) Acute No No effect59 Meier et al60 (311) Beneficial60 Presence of collaterals in affected territory None/minimal, moderate/max Gonner et al61 (43) Acute No No effect61 Brekenfeld et al62 (294) Beneficial62 Note:—NS indicates not stated; N/A, not applicable; ASPECTS, Alberta Stroke Program Early CT Score; max., maximal; PCA, posterior cerebral artery.
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↵a Proposal on working group on collateral grading.
Modality Description Grading Author (No.) Acute (<24 hr from Symptom Onset)/Non-Acute Reliability Assessed? Prognostic Significance of Good Collateral Flow Grade in Acute Stroke Axial CTA-SI Extent of perilesional vessel filling None, moderate, good, excellent Liebeskind64 (36) Acute Yes, ICC = 0.81 NS CTA-SI Comparison of Sylvian collaterals with contralateral hemisphere Absent, less, equal to, greater than contralateral hemisphere, exuberant Rosenthal et al65 (44) Acute No Beneficial65–67 Maas et al66 (135) Lima et al67 (196) CTA-SI and MPR Extent of perilesional enhancement Good, poor Schramm et al68 (20) Acute Yes, κ = 0.494 Beneficial68,69 Tan et al69 (113) CTA-SI and reconstructions MCA filling in Sylvian fissure Good, moderate, absent Wildermuth et al70 (40) Acute Yes Beneficial70,71 Knauth et al71 (21) 88% agreement between 2 raters71 CTA MIP Extent of filling in territory of occluded vessel 0–3 Tan et al69 (113) Acute Yes Beneficial69.72,73 Tan et al72 (85) κ = 0.66969, ICC 0.8772 Soares et al73 (22) CTA, MIP, CTP Retrograde filling of MCA Good, moderate, poor Miteff et al5 (92) Acute Yes Beneficial κ = 0.93 (TCTP) Extent of perfusion deficit on TCTP Severe, moderate Lee et al34 Acute No NS Note:—NS indicates not stated; ICC, intraclass correlation coefficient; CTA-SI, CT angiography source images; MPR, multiplanar reconstruction; MIP, maximum intensity projection; TPCT, triphasic CTP.
Modality Description Author (No.) Acute (<24 hr from Symptom Onset)/Nonacute Reliability Assessed? Prognostic Significance of Good Collateral Flow Grade in Acute Stroke FADS Late FADS implies collateral flow Martel et al84 (22) Acute No NS QMRA Increased flow ipsilateral to steno-occlusive disease Ruland et al83 (16) Nonacute No N/A Phase-contrast MRA Flow from posterior to anterior circulation Schomer et al82 (29) Nonacute No N/A FLAIR FLAIR hyperintensities as a marker of collateral flow Liebeskind85 (91) Acute No NS85,19,27,31,81 Kamran et al27 (8) Noguchi et al31 (5) Sanossian et al19 (74) Lee et al81 (52) T2*-weighted MRI Abnormal visualization of leptomeningeal vessels Hermier et al80 (48) Acute No NS PWI Delayed perfusion sign visualized on PWI Hermier et al79 (29) Acute No NS ASL Quantitative distal collateral flow measurement Wu et al13 (51) Nonacute No N/A TASL Collateral flow assessment based on ASPECTS Chng et al51 (18) Nonacute No N/A CASL Collateral flow inferred from delayed arterial flow Chalela et al78 (15) Acute No NS Note:—NS indicates not stated; N/A, not applicable; FADS, factor analysis of dynamic structures; QMRA, quantitative MRA; TASL, territorial arterial spin labelling; CASL, continuous arterial spin-labeled/labeling; ASPECTS, Alberta Stroke Program Early CT Score.
Description Author (No.) Acute (<24 hr from Symptom Onset)/Nonacute Reliability Assessed? Prognostic Significance of Good Collateral Flow Grade in Acute Stroke Asymmetry of flow in ipsilateral ACA and PCA Zanette et al77 (56) Acute No NS Asymmetric P2 flow and reduced pulsatility Reinhard et al76 (30) Nonacute No N/A Reinhard et al75 (111) Asymmetric mean blood velocity in proximal ACA or P2 segment of ACA Muller and Schimrigk2 (48) Nonacute No N/A Accelerated flow in A1 segment of ACA Kaps et al74 (23) Acute No NS Flow direction relative to Doppler probe Hennerici et al86,a Unclear No NS Asymmetric flow velocity and pulsatility index Kim et al35 (51) Acute No NS Note:—NS indicates not stated; N/A, not applicable.
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↵a Number not stated.
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