Journal article
Impact of Age and Alberta Stroke Program Early Computed Tomography Score 0 to 5 on Mechanical Thrombectomy Outcomes Analysis From the STRATIS Registry
Stroke (1970), Vol.52(7), pp.2220-2228
07/01/2021
DOI: 10.1161/STROKEAHA.120.032430
PMCID: PMC8240495
PMID: 34078106
Abstract
BACKGROUND AND PURPOSE: This study investigates clinical outcomes after mechanical thrombectomy in adult patients with baseline Alberta Stroke Program Early CT Score (ASPECTS) of 0 to 5.
METHODS: We included data from the STRATIS Registry (Systematic Evaluation of Patients Treated With Neurothrombectomy Devices for Acute Ischemic Stroke) from patients who underwent mechanical thrombectomy within 8 hours of symptom onset and had available ASPECTS data adjudicated by an independent core laboratory. Angiographic and clinical outcomes were collected, including successful reperfusion (modified Thrombolysis in Cerebral Infarction >= 2b), functional independence (modified Rankin Scale score 0-2), 90-day mortality, and symptomatic intracranial hemorrhage at 24 hours. Outcomes were stratified by ASPECTS scores and age.
RESULTS: Of the 984 patients enrolled, 763 had available ASPECTS data. Of these patients, 57 had ASPECTS of 0 to 5 with a median age of 63 years (interquartile range, 28-100), whereas 706 patients had ASPECTS of 6 to 10 with a median age of 70 years of age (interquartile range, 19-100). Ten patients had ASPECTS of 0 to 3 and 47 patients had ASPECTS of 4 to 5 at baseline. Successful reperfusion was achieved in 85.5% (47/55) in the ASPECTS of 0 to 5 group. Functional independence was achieved in 28.8% (15/52) in the ASPECTS of 0 to 5 versus 59.7% (388/650) in the 6 to 10 group (P<0.001). Mortality rates were 30.8% (16/52) in the ASPECTS of 0 to 5 and 13.4% (87/650) in the 6 to 10 group (P<0.001). sICH rates were 7.0% (4/57) in the ASPECTS of 0 to 5 and 0.9% (6/682) in the 6 to 10 group (P<0.001). No patients aged >75 years with ASPECTS of 0 to 5 (0/12) achieved functional independence versus 44.8% (13/29) of those age <= 65 (P=0.005).
CONCLUSIONS: Patients <65 years of age with large core infarction (ASPECTS 0-5) have better rates of functional independence and lower rates of mortality compared with patients >75 years of age.
Details
- Title: Subtitle
- Impact of Age and Alberta Stroke Program Early Computed Tomography Score 0 to 5 on Mechanical Thrombectomy Outcomes Analysis From the STRATIS Registry
- Creators
- Osama O. Zaidat - Neuroscience Institute, St Vincent Mercy Hospital, Toledo, OH (O.O.Z., S.B.).David S. Liebeskind - University of California, Los AngelesAshutosh P. Jadhav - University of Pittsburgh Medical CenterSantiago Ortega-Gutierrez - Roy J. and Lucille A. Carver College of MedicineThanh N. Nguyen - Boston Medical CenterDiogo C. Haussen - Emory UniversityDileep R. Yavagal - University of MiamiMichael T. Froehler - Vanderbilt University Medical CenterReza Jahan - University of California, Los AngelesRaul G. Nogueira - Emory UniversityTom L. Yao - Norton HealthcareBader A. Alenzi - The Ohio State University Wexner Medical CenterSaif Bushnaq - Neuroscience Institute, St Vincent Mercy Hospital, Toledo, OH (O.O.Z., S.B.).Nils H. Mueller-Kronast - Collaborative Neuroscience Network
- Resource Type
- Journal article
- Publication Details
- Stroke (1970), Vol.52(7), pp.2220-2228
- DOI
- 10.1161/STROKEAHA.120.032430
- PMID
- 34078106
- PMCID
- PMC8240495
- NLM abbreviation
- Stroke
- ISSN
- 0039-2499
- eISSN
- 1524-4628
- Publisher
- Lippincott Williams & Wilkins
- Number of pages
- 9
- Grant note
- Medtronic, Inc.; Medtronic
- Language
- English
- Date published
- 07/01/2021
- Academic Unit
- Neurology; Radiology; Iowa Neuroscience Institute; Neurosurgery
- Record Identifier
- 9984303015602771
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