{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T04:55:45Z","timestamp":1776142545942,"version":"3.50.1"},"reference-count":23,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T00:00:00Z","timestamp":1776124800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Stroke"],"abstract":"<jats:sec>\n                    <jats:title>Background and purpose<\/jats:title>\n                    <jats:p>Endovascular therapy (EVT) is increasingly offered to patients with large-core acute ischemic stroke (AIS), yet outcomes remain highly heterogeneous. Collateral circulation may be a key determinant of infarct evolution and recovery, but its role in early-window large-core stroke is not fully defined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed consecutive adults from a prospective stroke registry who presented within 6 h with anterior-circulation large-vessel occlusion, NIHSS \u22656, and a large ischemic core (MRI core &amp;gt;50 mL or CT perfusion core &amp;gt;70 mL, up to 150 mL). All patients received reperfusion therapy (intravenous thrombolysis, EVT, or both). Collateral status on baseline single-phase CTA was graded using the Tan scale (0\u20133); no patients had grade 3. The primary outcome was 90-day modified Rankin Scale (mRS); secondary outcome was NIHSS at discharge.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Fifty-four patients met inclusion criteria (Tan 0:\n                      <jats:italic>n<\/jats:italic>\n                      = 24; Tan 1:\n                      <jats:italic>n<\/jats:italic>\n                      = 14; Tan 2:\n                      <jats:italic>n<\/jats:italic>\n                      = 16). Baseline NIHSS, ASPECTS, and core volume were similar across groups. Patients without collaterals (Tan 0) had worse 90-day outcomes (median mRS 4 [IQR 3\u20136]) compared with those with Tan 1 (2 [IQR 1\u20133]) or Tan 2 (1 [IQR 1\u20132]) collaterals (both p &amp;lt; 0.001), whereas Tan 1 and Tan 2 did not differ significantly (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.27). NIHSS at discharge showed a similar gradient. In proportional-odds logistic regression, each one-grade increase in collateral status was associated with lower odds of worse 90-day mRS (adjusted per-grade OR 0.32; 95% CI 0.15\u20130.68;\n                      <jats:italic>p<\/jats:italic>\n                      = 0.003).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In early-treated large-core AIS, even simple CTA-based collateral assessment strongly predicts recovery. Patients with absent collaterals follow a distinctly poorer trajectory, while those with any collateral filling behave more favorably. Incorporating collateral status into routine evaluation may improve prognostic accuracy and support treatment decisions in this challenging subgroup.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fstro.2026.1755828","type":"journal-article","created":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T04:21:40Z","timestamp":1776140500000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Collateral status predicts functional outcome in early-treated large-core anterior circulation stroke"],"prefix":"10.3389","volume":"5","author":[{"given":"Andr\u00e9s","family":"Gallardo","sequence":"first","affiliation":[{"name":"Department of Neurology, Hospital Base Valdivia","place":["Valdivia, Chile"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pablo M.","family":"Lavados","sequence":"additional","affiliation":[{"name":"Department of Neurology and Psychiatry, Cl\u00ednica Alemana \u2013 Universidad del Desarrollo","place":["Santiago, Chile"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pablo","family":"Albi\u00f1a-Palmarola","sequence":"additional","affiliation":[{"name":"Neuroradiologische Klinik, Kopf- und Neurozentrum, Klinikum Stuttgart","place":["Stuttgart, Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriel","family":"Cavada","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, School of Public Health, University of Chile","place":["Santiago, Chile"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andr\u00e9s","family":"Rold\u00e1n","sequence":"additional","affiliation":[{"name":"Department of Neurology, Hospital Base Valdivia","place":["Valdivia, Chile"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ver\u00f3nica V.","family":"Olavarr\u00eda","sequence":"additional","affiliation":[{"name":"Department of Neurology and Psychiatry, Cl\u00ednica Alemana \u2013 Universidad del Desarrollo","place":["Santiago, Chile"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,14]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"708","DOI":"10.1056\/NEJMoa1713973","article-title":"Thrombectomy for stroke at 6 to 16 hours with selection by perfusion imaging","volume":"378","author":"Albers","year":"2018","journal-title":"N. 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