Journal article
Comparative Outcomes of Mechanical Thrombectomy in Acute Ischemic Stroke Patients with ASPECTS 2-3 vs. 4-5
Journal of stroke and cerebrovascular diseases, Vol.33(2), 107528
12/21/2023
DOI: 10.1016/j.jstrokecerebrovasdis.2023.107528
PMID: 38134550
Abstract
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.
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.
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.
AIS patients with LVO undergoing MT with ASPECTS 2-3 had similar outcomes compared to ASPECTS 4-5.
Details
- Title: Subtitle
- Comparative Outcomes of Mechanical Thrombectomy in Acute Ischemic Stroke Patients with ASPECTS 2-3 vs. 4-5
- Creators
- Atakan Orscelik - Medical University of South CarolinaHidetoshi MatsukawaSameh Samir Elawady - Medical University of South CarolinaMohamed Mahdi Sowlat - Medical University of South CarolinaConor Cunningham - Medical University of South CarolinaSara Zandpazandi - Medical University of South CarolinaRahim Abo Kasem - Medical University of South CarolinaIlko Maier - Department of Neurology, University Medicine Goettingen, Goettingen, Germany. Electronic address: ilko.maier@med.uni-goettingen.dePascal Jabbour - Thomas Jefferson UniversityJoon-Tae Kim - Chonnam National University HospitalStacey Quintero Wolfe - Department of Neurosurgery, Wake Forest School of Medicine, Winston-Salem, NC, USA. Electronic address: sqwolfe@wakehealth.eduAnsaar Rai - West Virginia UniversityRobert M Starke - University of MiamiMarios-Nikos Psychogios - University of BaselAmir Shaban - Department of Neurology, University of Iowa, Iowa City, IA, USA. Electronic address: amir-shaban@uiowa.eduNitin Goyal - University of Tennessee at KnoxvilleShinichi Yoshimura - Hyogo Medical UniversityHugo Cuellar - Department of Neurosurgery, Louisiana State University Health, Shreveport, LA, USA. Electronic address: hcuell@lsuhsc.eduBrian Howard - Emory University School of MedicineAli Alawieh - Emory University School of MedicineDaniele G Romano - University of SalernoOmar Tanweer - Baylor College of MedicineJustin Mascitelli - The University of Texas Health Science Center at San AntonioIsabel Fragata - Department of Neuroradiology, Centro Hospitalar Universitario de Lisboa Central, Lisboa, Portugal. Electronic address: isabelfragata@gmail.comAdam Polifka - Department of Neurosurgery, University of Florida, Gainesville, Florida, USA. Electronic address: adam.polifka@neurosurgery.ufl.eduJoshua Osbun - Washington University in St. LouisRoberto Crosa - Department of Neurosurgery, Endovascular Neurological Center, Medica Uruguaya, Montevideo, Uruguay. Electronic address: rocrossa@gmail.comCharles Matouk - Yale School of MedicineMin S Park - University of VirginiaMichael R Levitt - University of Washington School of MedicineWaleed Brinjikji - Department of Radiology, Mayo Clinic, Rochester, MN, USA. Electronic address: brinjikji.waleed@mayo.eduMark Moss - Washington Regional Medical CenterTravis Dumont - University of ArizonaRichard Williamson Jr - Allegheny Health NetworkPedro Navia - Hospital Universitario La PazPeter Kan - The University of Texas Medical Branch at GalvestonReade De Leacy - Icahn School of Medicine at Mount SinaiShakeel Chowdhry - Department of Neurosurgery, NorthShore University Health System, Chicago, IL, USA. Electronic address: schowdhry@northshore.orgMohamad Ezzeldin - University of HoustonAlejandro M Spiotta - Medical University of South CarolinaSami Al Kasab - Medical University of South CarolinaSTAR Collaborators
- Resource Type
- Journal article
- Publication Details
- Journal of stroke and cerebrovascular diseases, Vol.33(2), 107528
- DOI
- 10.1016/j.jstrokecerebrovasdis.2023.107528
- PMID
- 38134550
- NLM abbreviation
- J Stroke Cerebrovasc Dis
- eISSN
- 1532-8511
- Language
- English
- Date published
- 12/21/2023
- Academic Unit
- Neurology
- Record Identifier
- 9984533283802771
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