Collateral Circulation Grading System

collateral circulation grading system from the American Society of Interventional and Therapeutic Neuroradiology/American Society of Interventional Radiology (ASITN/SIR)

Grade 0: No collaterals visible to the ischemic site

Grade 1: Slow collaterals to the periphery of the ischemic site with persistence of some of the defect

Grade 2: Rapid collaterals to the periphery of ischemic site with persistence of some of the defect and to only a portion of the ischemic territory

Grade, 3: Collaterals with slow but complete angiographic blood flow of the ischemic bed by the late venous phase

Grade 4: Complete and rapid collateral blood flow to the vascular bed in the entire ischemic territory by retrograde perfusion

Grade of 0-1 indicates poor collateral circulation

Grade 2 indicates moderate collateral circulation

Grades of 3-4 indicate good collateral circulation

References

Chen, W., Song, X., Tian, D., Sun, H., Zhang, L., Hui, X., Ip, B. and Wang, X. (2019). Clinical efficacy of collateral circulation in the evaluation of endovascular treatment for acute internal carotid artery occlusion. Heliyon, 5(4), p.e01476.

R.T. Higashida, A.J. Furlan, H. Roberts, T. Tomsick, B. Connors, J. Barr, W. Dillon, S. Warach, J. Broderick, B. Tilley, D. Sacks, I. Technology Assessment Committee of the American Society of, N. Therapeutic, R. Technology Assessment Committee of the Society of Interventional, Trial design and reporting standards for intra-arterial cerebral thrombolysis for acute ischemic stroke, Stroke 34 (8) (2003) e109ee137.

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