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<p>Collateral circulation (CC) plays a critical role in stroke progression and vascular endothelial growth factor-A (VEGF-A) is a key angiogenic mediator. The aim of the study was to evaluate the association between VEGF-A plasma levels and CC in patients with acute ischemic stroke (AIS) due to large vessel occlusion (LVO) who received endovascular therapy (EVT).&#xa0;We conducted a prospective multicentre study of patients with LVO-AIS who received EVT. Blood samples were collected on admission to measure VEGF-A plasma levels. CC was assessed by automated collateral scoring on baseline CT angiography and classified from 0 to 3, later dichotomized into poor (0–1) and good (2–3) CC. Multivariable logistic regression analyses were performed to explore the association between VEGF-A and CC.&#xa0;Included were 290 patients (73.4 ± 13.5 years, 50.0% women), previous mRS median score was 0 (IQR 0–1) and the baseline NIHSS median score was 16 (IQR 9–20). Higher baseline VEGF-A levels were independently associated with better CC (cOR<sub>x1 log increase of VEGF−A</sub>= 1.83, 95% CI 1.18–2.83; <i>p</i> = 0.007) adjusted for age and known-onset of symptoms &lt; 6&#xa0;h. A VEGF-A threshold &lt; 14pg/mL identified poor CC with high specificity (75.2%) and was inversely associated with the probability of presenting good CC (aOR = 0.53, 95%CI 0.29–0.96; <i>p</i> = 0.036). No significant association was found between VEGF-A levels and 3-months functional outcome.&#xa0;Circulating VEGF-A levels wereindependently associated with CC status in AIS patients with anterior LVO treated with EVT. While this finding suggests a potential biological link between VEGF-A and collateral function, it should be interpreted as an association rather than a causal relationship.</p>

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Vascular Endothelial Growth Factor-A and Collateral Circulation in Patients with Acute Ischemic Stroke due to Intracranial Large Vessel Occlusion

  • 期刊论文

  • 发表日期：

    2025年12月2日

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  • Ana Aguilera-Simón,
  • Marina Guasch-Jiménez,
  • Francisco Moniche,
  • Núria Puig,
  • Blanca Pardo-Galiana,
  • Sònia Benítez,
  • Maria del Mar Freijo,
  • Rebeca Marín,
  • Alain Luna,
  • Cristina Gallego-Fabrega,
  • Isabel Fernández-Pérez,
  • Garbiñe Ezcurra-Díaz,
  • Jordi Jiménez-Conde,
  • Álvaro Lambea-Gil,
  • Beatriz Gómez-Vicente,
  • Alejandro Martínez-Domeño,
  • Juan F. Arenillas,
  • Luis Prats-Sánchez,
  • Jorge Rodríguez-Pardo,
  • Anna Ramos-Pachón,
  • Elena de Celis-Ruiz,
  • José Pablo Martínez-González,
  • Santiago Trillo,
  • Joaquín Ortega-Quintanilla,
  • Joan Martí-Fàbregas,
  • Pol Camps-Renom

摘要

Collateral circulation (CC) plays a critical role in stroke progression and vascular endothelial growth factor-A (VEGF-A) is a key angiogenic mediator. The aim of the study was to evaluate the association between VEGF-A plasma levels and CC in patients with acute ischemic stroke (AIS) due to large vessel occlusion (LVO) who received endovascular therapy (EVT). We conducted a prospective multicentre study of patients with LVO-AIS who received EVT. Blood samples were collected on admission to measure VEGF-A plasma levels. CC was assessed by automated collateral scoring on baseline CT angiography and classified from 0 to 3, later dichotomized into poor (0–1) and good (2–3) CC. Multivariable logistic regression analyses were performed to explore the association between VEGF-A and CC. Included were 290 patients (73.4 ± 13.5 years, 50.0% women), previous mRS median score was 0 (IQR 0–1) and the baseline NIHSS median score was 16 (IQR 9–20). Higher baseline VEGF-A levels were independently associated with better CC (cORx1 log increase of VEGF−A= 1.83, 95% CI 1.18–2.83; p = 0.007) adjusted for age and known-onset of symptoms < 6 h. A VEGF-A threshold < 14pg/mL identified poor CC with high specificity (75.2%) and was inversely associated with the probability of presenting good CC (aOR = 0.53, 95%CI 0.29–0.96; p = 0.036). No significant association was found between VEGF-A levels and 3-months functional outcome. Circulating VEGF-A levels wereindependently associated with CC status in AIS patients with anterior LVO treated with EVT. While this finding suggests a potential biological link between VEGF-A and collateral function, it should be interpreted as an association rather than a causal relationship.