{"doi":"10.3174/ajnr.a8601","title":"The Cortical Vein Opacification Score (COVES) Is Independently Associated with DSA ASITN Collateral Score","abstract":"<h3>ABSTRACT</h3> <h3>Background:</h3> 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. <h3>Methods:</h3> 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 two 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’s rank correlation, univariable logistic regression, multivariable logistic regression, and receiver operating characteristic curve analysis were performed. A p-value of ≤0.05 was considered significant. <h3>Results:</h3> In total, 311 consecutive patients (median, IQR=68 years [59-78 years]; 55.9% female) met our inclusion criteria. There was significant positive correlation between COVES and ASITN CS (ρ=0.41,p&lt;0.001), and higher COVES was significantly and independently associated with good ASITN CS (unadjusted-OR=1.74,p&lt;0.001) and adjusted-OR=1.73, p&lt;0.001). ROC analysis showed AUC of 0.71, p&lt;0.001). <h3>Conclusion:</h3> In conclusion, 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; ASITN: American Society of Interventional and Therapeutic Neuroradiology; CS: Collateral status; COVES: Cortical Vein Opacification Score; HIR: Hypoperfusion Intensity Ratio; IVT: Intravenous thrombolysis; LVO: Large vessel occlusion; mRS: modified Rankin score; MT: mechanical thrombectomy; OR: odds ratio; aOR: adjusted odds ratio; ua: unadjusted odds ratio; rCBF: relative cerebral blood flow; Tmax: Time-to-Maximum","journal":"American Journal of Neuroradiology","year":2024,"id":437477,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":11,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9635,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":414112,"name":"Aneri Balar","orcid":"0000-0002-3592-708X","position":1,"is_corresponding":false},{"id":1246367,"name":"Subtain Ali","orcid":"0000-0002-9522-9881","position":2,"is_corresponding":false},{"id":363279,"name":"M. 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Lakhani","orcid":"0000-0001-7577-1887","position":0,"is_corresponding":true}],"reference_count":47,"raw_metadata":null,"created_at":"2026-07-19T02:00:29.872940Z","pmid":"39578105","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}