Background and Purpose:White matter hyperintensity (WMH), a marker of chronic cerebral small vessel disease, might impact the recruitment of leptomeningeal collaterals. We aimed to assess whether the WMH burden is associated with collateral circulation in patients treated by endovascular thrombectomy for anterior circulation acute ischemic stroke.Methods:Consecutive acute ischemic stroke due to anterior circulation large vessel occlusion and treated with endovascular thrombectomy from January 2015 to December 2017 were included. WMH volumes (periventricular, deep, and total) were assessed by a semiautomated volumetric analysis on fluid-attenuated inversion recovery–magnetic resonance imaging. Collateral status was graded on baseline catheter angiography using the American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology grading system (good when ≥3). We investigated associations of WMH burden with collateral status.Results:A total of 302 patients were included (mean age, 69.1±19.4 years; women, 55.6%). Poor collaterals were observed in 49.3% of patients. Median total WMH volume was 3.76 cm³ (interquartile range, 1.09–11.81 cm³). The regression analyses showed no apparent relationship between WMH burden and the collateral status measured at baseline angiography (adjusted odds ratio, 0.987 [95% CI, 0.971–1.003]; P=0.12).Conclusions:WMH burden exhibits no overt association with collaterals in large vessel occlusive stroke.

中文翻译：

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大血管闭塞中风的白质高信号负荷和侧支循环

背景和目的：白质高信号 (WMH) 是慢性脑小血管疾病的标志物，可能会影响软脑膜侧支的募集。我们旨在评估 WMH 负荷是否与前循环急性缺血性卒中血管内取栓治疗患者的侧支循环相关。方法：2015 年 1 月至 2017 年 12 月因前循环大血管闭塞导致的连续急性缺血性卒中并接受血管内取栓治疗被包括在内。通过流体衰减反转恢复-磁共振成像的半自动体积分析评估 WMH 体积（脑室周围、深部和总体积）。使用美国介入和治疗性神经放射学会/介入放射学会分级系统对基线导管血管造影对侧支状态进行分级（≥3 时良好）。我们调查了 WMH 负担与侧支状态的关联。结果：共纳入 302 名患者（平均年龄，69.1±19.4 岁；女性，55.6%）。在 49.3% 的患者中观察到侧支循环不良。WMH 总体积中位数为 3.76 厘米³（四分位距，1.09–11.81 cm ³）。回归分析表明WMH负担和在基线血管造影术测定的附带状态之间没有明显的关系（校正比值比，0.987 [95％CI，0.971-1.003]; P = 0.12）。结论：WMH负担表现出与在络没有明显的关联大血管闭塞性中风。