TY - JOUR
T1 - Comparative Outcomes of Mechanical Thrombectomy in Acute Ischemic Stroke Patients with ASPECTS 2-3 vs. 4-5
AU - STAR Collaborators
AU - Orscelik, Atakan
AU - Matsukawa, Hidetoshi
AU - Elawady, Sameh Samir
AU - Sowlat, Mohamed Mahdi
AU - Cunningham, Conor
AU - Zandpazandi, Sara
AU - Kasem, Rahim Abo
AU - Maier, Ilko
AU - Jabbour, Pascal
AU - Kim, Joon Tae
AU - Wolfe, Stacey Quintero
AU - Rai, Ansaar
AU - Starke, Robert M.
AU - Psychogios, Marios Nikos
AU - Shaban, Amir
AU - Goyal, Nitin
AU - Yoshimura, Shinichi
AU - Cuellar, Hugo
AU - Howard, Brian
AU - Alawieh, Ali
AU - Romano, Daniele G.
AU - Tanweer, Omar
AU - Mascitelli, Justin
AU - Fragata, Isabel
AU - Polifka, Adam
AU - Osbun, Joshua
AU - Crosa, Roberto
AU - Matouk, Charles
AU - Park, Min S.
AU - Levitt, Michael R.
AU - Brinjikji, Waleed
AU - Moss, Mark
AU - Dumont, Travis
AU - Williamson, Richard
AU - Navia, Pedro
AU - Kan, Peter
AU - De Leacy, Reade
AU - Chowdhry, Shakeel
AU - Ezzeldin, Mohamad
AU - Spiotta, Alejandro M.
AU - Kasab, Sami Al
N1 - Publisher Copyright:
© 2023
PY - 2024/2
Y1 - 2024/2
N2 - Background: The influence of Alberta Stroke Program Early CT Score (ASPECTS) on outcomes following mechanical thrombectomy (MT) for acute ischemic stroke (AIS) patients with low ASPECTS remains unknown. In this study, we compared the outcomes of AIS patients treated with MT for large vessel occlusion (LVO) categorized by ASPECTS value. Methods: We conducted a retrospective analysis involving 305 patients with AIS caused by LVO, defined as the occlusion of the internal carotid artery and/or the M1 segments of the middle cerebral artery, stratified into two groups: ASPECTS 2-3 and 4-5. The primary outcome was favorable outcome defined as a 90-day modified Rankin Scale (mRS) score of 0-3. Secondary outcomes were 90-day mRS 0-2, 90-day mortality, any intracerebral hemorrhage (ICH), and symptomatic ICH (sICH). We performed multivariable logistic regression analysis to evaluate the impact of ASPECTS 2-3 vs. 4-5 on outcomes. Results: Fifty-nine patients (19.3%) had ASPECTS 2-3 and 246 (80.7%) had ASPECTS 4-5. Favorable outcomes showed no significant difference between the two groups (adjusted odds ratio [aOR]= 1.13, 95% confidence interval [CI]: 0.52-2.41, p=0.80). There were also no significant differences in 90-day mRS 0-2 (aOR= 1.65, 95% CI: 0.66-3.99, p=0.30), 90-day mortality (aOR= 1.14, 95% CI: 0.58-2.20, p=0.70), any ICH (aOR= 0.54, 95% CI: 0.28-1.00, p=0.06), and sICH (aOR= 0.70, 95% CI: 0.27-1.63, p = 0.40) between the groups. Conclusions: AIS patients with LVO undergoing MT with ASPECTS 2-3 had similar outcomes compared to ASPECTS 4-5.
AB - Background: The influence of Alberta Stroke Program Early CT Score (ASPECTS) on outcomes following mechanical thrombectomy (MT) for acute ischemic stroke (AIS) patients with low ASPECTS remains unknown. In this study, we compared the outcomes of AIS patients treated with MT for large vessel occlusion (LVO) categorized by ASPECTS value. Methods: We conducted a retrospective analysis involving 305 patients with AIS caused by LVO, defined as the occlusion of the internal carotid artery and/or the M1 segments of the middle cerebral artery, stratified into two groups: ASPECTS 2-3 and 4-5. The primary outcome was favorable outcome defined as a 90-day modified Rankin Scale (mRS) score of 0-3. Secondary outcomes were 90-day mRS 0-2, 90-day mortality, any intracerebral hemorrhage (ICH), and symptomatic ICH (sICH). We performed multivariable logistic regression analysis to evaluate the impact of ASPECTS 2-3 vs. 4-5 on outcomes. Results: Fifty-nine patients (19.3%) had ASPECTS 2-3 and 246 (80.7%) had ASPECTS 4-5. Favorable outcomes showed no significant difference between the two groups (adjusted odds ratio [aOR]= 1.13, 95% confidence interval [CI]: 0.52-2.41, p=0.80). There were also no significant differences in 90-day mRS 0-2 (aOR= 1.65, 95% CI: 0.66-3.99, p=0.30), 90-day mortality (aOR= 1.14, 95% CI: 0.58-2.20, p=0.70), any ICH (aOR= 0.54, 95% CI: 0.28-1.00, p=0.06), and sICH (aOR= 0.70, 95% CI: 0.27-1.63, p = 0.40) between the groups. Conclusions: AIS patients with LVO undergoing MT with ASPECTS 2-3 had similar outcomes compared to ASPECTS 4-5.
KW - Acute ischemic stroke
KW - ASPECTS
KW - Large ischemic infarct
KW - Large vessel occlusion
KW - Mechanical thrombectomy
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U2 - 10.1016/j.jstrokecerebrovasdis.2023.107528
DO - 10.1016/j.jstrokecerebrovasdis.2023.107528
M3 - Article
C2 - 38134550
AN - SCOPUS:85180940907
SN - 1052-3057
VL - 33
JO - Journal of Stroke and Cerebrovascular Diseases
JF - Journal of Stroke and Cerebrovascular Diseases
IS - 2
M1 - 107528
ER -