Skip to main content
Advertisement

Main menu

  • Home
  • Content
    • Current Issue
    • Accepted Manuscripts
    • Article Preview
    • Past Issue Archive
    • Video Articles
    • AJNR Case Collection
    • Case of the Week Archive
    • Case of the Month Archive
    • Classic Case Archive
  • Special Collections
    • AJNR Awards
    • Low-Field MRI
    • Alzheimer Disease
    • ASNR Foundation Special Collection
    • Photon-Counting CT
    • View All
  • Multimedia
    • AJNR Podcasts
    • AJNR SCANtastic
    • Trainee Corner
    • MRI Safety Corner
    • Imaging Protocols
  • For Authors
    • Submit a Manuscript
    • Submit a Video Article
    • Submit an eLetter to the Editor/Response
    • Manuscript Submission Guidelines
    • Statistical Tips
    • Fast Publishing of Accepted Manuscripts
    • Graphical Abstract Preparation
    • Imaging Protocol Submission
    • Author Policies
  • About Us
    • About AJNR
    • Editorial Board
    • Editorial Board Alumni
  • More
    • Become a Reviewer/Academy of Reviewers
    • Subscribers
    • Permissions
    • Alerts
    • Feedback
    • Advertisers
    • ASNR Home

User menu

  • Alerts
  • Log in

Search

  • Advanced search
American Journal of Neuroradiology
American Journal of Neuroradiology

American Journal of Neuroradiology

ASHNR American Society of Functional Neuroradiology ASHNR American Society of Pediatric Neuroradiology ASSR
  • Alerts
  • Log in

Advanced Search

  • Home
  • Content
    • Current Issue
    • Accepted Manuscripts
    • Article Preview
    • Past Issue Archive
    • Video Articles
    • AJNR Case Collection
    • Case of the Week Archive
    • Case of the Month Archive
    • Classic Case Archive
  • Special Collections
    • AJNR Awards
    • Low-Field MRI
    • Alzheimer Disease
    • ASNR Foundation Special Collection
    • Photon-Counting CT
    • View All
  • Multimedia
    • AJNR Podcasts
    • AJNR SCANtastic
    • Trainee Corner
    • MRI Safety Corner
    • Imaging Protocols
  • For Authors
    • Submit a Manuscript
    • Submit a Video Article
    • Submit an eLetter to the Editor/Response
    • Manuscript Submission Guidelines
    • Statistical Tips
    • Fast Publishing of Accepted Manuscripts
    • Graphical Abstract Preparation
    • Imaging Protocol Submission
    • Author Policies
  • About Us
    • About AJNR
    • Editorial Board
    • Editorial Board Alumni
  • More
    • Become a Reviewer/Academy of Reviewers
    • Subscribers
    • Permissions
    • Alerts
    • Feedback
    • Advertisers
    • ASNR Home
  • Follow AJNR on Twitter
  • Visit AJNR on Facebook
  • Follow AJNR on Instagram
  • Join AJNR on LinkedIn
  • RSS Feeds

AJNR Awards, New Junior Editors, and more. Read the latest AJNR updates

Research ArticleNeurointervention

The Cortical Vein Opacification Score (COVES) Is Independently Associated with DSA ASITN Collateral Score

Dhairya A. Lakhani, Aneri B. Balar, Subtain Ali, Musharaf Khan, Hamza Salim, Manisha Koneru, Sijin Wen, Richard Wang, Janet Mei, Argye E. Hillis, Jeremy J. Heit, Greg W. Albers, Adam A. Dmytriw, Tobias D. Faizy, Max Wintermark, Kambiz Nael, Ansaar T. Rai and Vivek S. Yedavalli
American Journal of Neuroradiology May 2025, 46 (5) 921-928; DOI: https://doi.org/10.3174/ajnr.A8601
Dhairya A. Lakhani
aFrom the Department of Radiology and Radiological Sciences (D.A.L., A.B.B., H.S., R.W., J.M., V.S.Y.), Johns Hopkins University, Baltimore, Maryland
bDepartment of Neuroradiology (D.A.L., S.A., M. Khan, A.T.R.), West Virginia University, Morgantown, West Virginia
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for Dhairya A. Lakhani
Aneri B. Balar
aFrom the Department of Radiology and Radiological Sciences (D.A.L., A.B.B., H.S., R.W., J.M., V.S.Y.), Johns Hopkins University, Baltimore, Maryland
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Subtain Ali
bDepartment of Neuroradiology (D.A.L., S.A., M. Khan, A.T.R.), West Virginia University, Morgantown, West Virginia
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for Subtain Ali
Musharaf Khan
bDepartment of Neuroradiology (D.A.L., S.A., M. Khan, A.T.R.), West Virginia University, Morgantown, West Virginia
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Hamza Salim
aFrom the Department of Radiology and Radiological Sciences (D.A.L., A.B.B., H.S., R.W., J.M., V.S.Y.), Johns Hopkins University, Baltimore, Maryland
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for Hamza Salim
Manisha Koneru
cCooper Medical School of Rowan University (M. Koneru), Camden, New Jersey
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Sijin Wen
dDepartment of Biostatistics (S.W.), West Virginia University, Morgantown, West Virginia
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Richard Wang
aFrom the Department of Radiology and Radiological Sciences (D.A.L., A.B.B., H.S., R.W., J.M., V.S.Y.), Johns Hopkins University, Baltimore, Maryland
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Janet Mei
aFrom the Department of Radiology and Radiological Sciences (D.A.L., A.B.B., H.S., R.W., J.M., V.S.Y.), Johns Hopkins University, Baltimore, Maryland
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Argye E. Hillis
eDepartment of Neurology (A.E.H.), Johns Hopkins University, Baltimore, Maryland
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Jeremy J. Heit
fDepartment of Neurology (J.J.H., G.W.A.), Stanford University, Stanford, California
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for Jeremy J. Heit
Greg W. Albers
fDepartment of Neurology (J.J.H., G.W.A.), Stanford University, Stanford, California
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Adam A. Dmytriw
gDepartment of Radiology (A.A.D.), Harvard Medical School, Boston, Massachusetts
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for Adam A. Dmytriw
Tobias D. Faizy
hDepartment of Radiology (T.D.F.), Neuroendovascular Division, University Medical Center Münster, Münster, Germany
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Max Wintermark
iDepartment of Neuroradiology (M.W.), MD Anderson Medical Center, Houston, Texas
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for Max Wintermark
Kambiz Nael
jDivision of Neuroradiology (K.N.), Department of Radiology, University of California San Francisco, San Francisco, California
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for Kambiz Nael
Ansaar T. Rai
bDepartment of Neuroradiology (D.A.L., S.A., M. Khan, A.T.R.), West Virginia University, Morgantown, West Virginia
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for Ansaar T. Rai
Vivek S. Yedavalli
aFrom the Department of Radiology and Radiological Sciences (D.A.L., A.B.B., H.S., R.W., J.M., V.S.Y.), Johns Hopkins University, Baltimore, Maryland
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Data
  • Supplemental
  • Info & Metrics
  • Responses
  • References
  • PDF
Loading

This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.

Graphical Abstract

Figure
  • Download figure
  • Open in new tab
  • Download powerpoint

Abstract

BACKGROUND AND PURPOSE: Pretreatment CTA-based Cortical Vein Opacification Score (COVES) has been shown to predict good functional outcomes at 90 days in patients with acute ischemic stroke secondary to large vessel occlusion (AIS-LVO). This is thought to be related to its ability to measure collateral status (CS). However, its association with the reference standard test, the DSA-based American Society of Interventional and Therapeutic Neuroradiology (ASITN) collateral score, has yet to be established. Therefore, this study assesses the relationship between COVES and ASITN CS.

MATERIALS AND METHODS: In this prospectively collected, retrospectively reviewed analysis, patients with anterior circulation LVO from September 1, 2017, to October 1, 2023, were included. The COVES grading, which ranges from 0 to 6, was independently assessed by 2 board-certified neuroradiologists. The ASITN CS was independently assessed by a board-certified neuroradiologist and the performing neurointerventionalist. Any discrepancies were resolved through consensus review. Spearman rank correlation, univariable logistic regression, multivariable logistic regression, and receiver operating characteristic curve analysis were performed. A P value of ≤ .05 was considered significant.

RESULTS: In total, 311 consecutive patients (median, IQR = 68 years [59–78 years]; 55.9% women) met our inclusion criteria. There was significant positive correlation between COVES and ASITN CS (ρ = 0.41, P < .001), and higher COVES was significantly and independently associated with good ASITN CS (unadjusted-OR = 1.74, P < .001) and adjusted-OR = 1.73, P < .001). Receiver operating characteristic curve analysis showed area under the curve of 0.71, P < .001).

CONCLUSIONS: By demonstrating the independent association of COVES with the reference standard test for collateral status assessment, the ASITN CS, we further validate the role of COVES in estimating collateral status.

ABBREVIATIONS:

AIS
acute ischemic stroke
aOR
adjusted odds ratio
ASITN
American Society of Interventional and Therapeutic Neuroradiology
AUC
area under the curve
CS
collateral status
COVES
Cortical Vein Opacification Score
ECASS
European-Australasian Acute Stroke Study
HIR
hypoperfusion intensity ratio
IVT
intravenous thrombolysis
LVO
large vessel occlusion
mCTA
multiphase CTA
MT
mechanical thrombectomy
OR
odds ratio
PH
parenchymal hematoma
rCBF
relative cerebral blood flow
ROC
receiver operating characteristic curve
Tmax
time to maximum
uaOR
unadjusted odds ratio
VO
venous outflow
  • © 2025 by American Journal of Neuroradiology
View Full Text

Log in using your username and password

Forgot your user name or password?

Log in through your institution

You may be able to gain access using your login credentials for your institution. Contact your library if you do not have a username and password.
PreviousNext
Back to top

In this issue

American Journal of Neuroradiology: 46 (5)
American Journal of Neuroradiology
Vol. 46, Issue 5
1 May 2025
  • Table of Contents
  • Index by author
  • Complete Issue (PDF)
Advertisement
Print
Download PDF
Email Article

Thank you for your interest in spreading the word on American Journal of Neuroradiology.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
The Cortical Vein Opacification Score (COVES) Is Independently Associated with DSA ASITN Collateral Score
(Your Name) has sent you a message from American Journal of Neuroradiology
(Your Name) thought you would like to see the American Journal of Neuroradiology web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Cite this article
Dhairya A. Lakhani, Aneri B. Balar, Subtain Ali, Musharaf Khan, Hamza Salim, Manisha Koneru, Sijin Wen, Richard Wang, Janet Mei, Argye E. Hillis, Jeremy J. Heit, Greg W. Albers, Adam A. Dmytriw, Tobias D. Faizy, Max Wintermark, Kambiz Nael, Ansaar T. Rai, Vivek S. Yedavalli
The Cortical Vein Opacification Score (COVES) Is Independently Associated with DSA ASITN Collateral Score
American Journal of Neuroradiology May 2025, 46 (5) 921-928; DOI: 10.3174/ajnr.A8601

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
0 Responses
Respond to this article
Share
Bookmark this article
COVES is Linked to DSA ASITN Collateral Score
Dhairya A. Lakhani, Aneri B. Balar, Subtain Ali, Musharaf Khan, Hamza Salim, Manisha Koneru, Sijin Wen, Richard Wang, Janet Mei, Argye E. Hillis, Jeremy J. Heit, Greg W. Albers, Adam A. Dmytriw, Tobias D. Faizy, Max Wintermark, Kambiz Nael, Ansaar T. Rai, Vivek S. Yedavalli
American Journal of Neuroradiology May 2025, 46 (5) 921-928; DOI: 10.3174/ajnr.A8601
del.icio.us logo Twitter logo Facebook logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One
Purchase

Jump to section

  • Article
    • Graphical Abstract
    • Abstract
    • ABBREVIATIONS:
    • MATERIALS AND METHODS
    • RESULTS
    • DISCUSSION
    • CONCLUSIONS
    • Acknowledgments
    • Footnotes
    • References
  • Figures & Data
  • Supplemental
  • Info & Metrics
  • Responses
  • References
  • PDF

Related Articles

  • PubMed
  • Google Scholar

Cited By...

  • No citing articles found.
  • Crossref (4)
  • Google Scholar

This article has been cited by the following articles in journals that are participating in Crossref Cited-by Linking.

  • Factors Associated With Prolonged Venous Transit in Large Vessel Occlusion Acute Ischemic Strokes
    Hamza Adel Salim, Dhairya A. Lakhani, Aneri B. Balar, Janet Mei, Licia Luna, Mona Shahriari, Nathan Z. Hyson, Francis Deng, Adam A. Dmytriw, Adrien Guenego, Victor C. Urrutia, Elisabeth B. Marsh, Hanzhang Lu, Risheng Xu, Rich Leigh, Gaurang Shah, Sijin Wen, Gregory W. Albers, Argye E. Hillis, Rafael Llinas, Kambiz Nael, Max Wintermark, Jeremy J. Heit, Tobias D. Faizy, Vivek S. Yedavalli
    Journal of Neuroimaging 2025 35 1
  • Volume contracted state, mortality and functional outcomes in patients with acute ischaemic stroke due to large vessel occlusion
    Vivek Yedavalli, Hamza Adel Salim, Dhairya A Lakhani, Janet Mei, Licia P Luna, Yasmin Aziz, Vaibhav Vagal, Adam A Dmytriw, Adrien Guenego, Victor Urrutia, Elisabeth B Marsh, Aakanksha Sriwastwa, Raf Llinas, Hanzhang Lu, Risheng Xu, Dylan Wolman, Benjamin Pulli, Argye Hillis, Gregory W Albers, Max Wintermark, Kambiz Nael, Jeremy J Heit, Tobias D Faizy, Mona N Bahouth
    BMJ Neurology Open 2025 7 1
  • Single‐ and Multiphase CT Angiography Is Associated With Digital Subtraction Angiography Collateral Score ≥3
    Tara Srinivas, Dhairya A. Lakhani, Aneri B. Balar, Risheng Xu, Jee Moon, Caline Azzi, Nathan Hyson, Mona Shahriari, Sijin Wen, Cynthia Greene, Janet Mei, Farzad Maroufi, Jeremy J. Heit, Tobias D. Faizy, Gregory W. Albers, Hamza Salim, Meisam Hoseinyazdi, Vivek S. Yedavalli
    Journal of Neuroimaging 2025 35 3
  • The relative cerebral blood volume (rCBV) &lt;42% is independently associated with prolonged hospitalization in anterior circulation large vessel occlusion
    Dhairya A Lakhani, Aneri B Balar, Vaibhav Vagal, Subtain Ali, Hamza Salim, Janet Mei, Musharaf Khan, Manisha Koneru, Sijin Wen, Hanzhang Lu, Richard Wang, Argye E Hillis, Jeremy J Heit, Greg W Albers, Adam A Dmytriw, Tobias Faizy, Max Wintermark, Kambiz Nael, Ansaar T Rai, Vivek S Yedavalli
    The Neuroradiology Journal 2025

More in this TOC Section

  • Factors Associated with Major Re-Recanalization following Second Coiling for Recanalized Aneurysms: A Multicenter Experience over 20 Years during Long-Term Follow-up
  • A Key Factor Shapes LS-DAVFs EVT Outcome
  • Optimizing Voxel Size in 3D Rotational Angiography
Show more NEUROINTERVENTION

Similar Articles

Advertisement

Indexed Content

  • Current Issue
  • Accepted Manuscripts
  • Article Preview
  • Past Issues
  • Editorials
  • Editor's Choice
  • Fellows' Journal Club
  • Letters to the Editor
  • Video Articles

Cases

  • Case Collection
  • Archive - Case of the Week
  • Archive - Case of the Month
  • Archive - Classic Case

More from AJNR

  • Trainee Corner
  • Imaging Protocols
  • MRI Safety Corner

Multimedia

  • AJNR Podcasts
  • AJNR Scantastics

Resources

  • Turnaround Time
  • Submit a Manuscript
  • Submit a Video Article
  • Submit an eLetter to the Editor/Response
  • Manuscript Submission Guidelines
  • Statistical Tips
  • Fast Publishing of Accepted Manuscripts
  • Graphical Abstract Preparation
  • Imaging Protocol Submission
  • Evidence-Based Medicine Level Guide
  • Publishing Checklists
  • Author Policies
  • Become a Reviewer/Academy of Reviewers
  • News and Updates

About Us

  • About AJNR
  • Editorial Board
  • Editorial Board Alumni
  • Alerts
  • Permissions
  • Not an AJNR Subscriber? Join Now
  • Advertise with Us
  • Librarian Resources
  • Feedback
  • Terms and Conditions
  • AJNR Editorial Board Alumni

American Society of Neuroradiology

  • Not an ASNR Member? Join Now

© 2025 by the American Society of Neuroradiology All rights, including for text and data mining, AI training, and similar technologies, are reserved.
Print ISSN: 0195-6108 Online ISSN: 1936-959X

Powered by HighWire