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Title: Borderline Aspect Score Patients with Acute Ischaemic Stroke Due to Large Vessel Occlusion May Find Benefit with Endovascular Thrombectomy
Austin Authors: Logan, Caitriona;Maingard, Julian;Phan, Kevin;Motyer, Ronan;Barras, Christen;Looby, Seamus;Brennan, Paul;O’Hare, Alan;Brooks, Duncan Mark ;Chandra, Ronil V;Asadi, Hamed ;Kok, Hong Kuan;Thornton, John
Affiliation: Interventional Neuroradiology Service, Department of Radiology, Beaumont Hospital, Dublin, Ireland
Interventional Neuroradiology Service – Radiology Department, Austin Health, Heidelberg, Victoria, Australia
NeuroSpine Surgery Research Group, Prince of Wales Private Hospital, Sydney, NSW, Australia
Lysholm Department of Neuroradiology, The National Hospital for Neurology and Neurosurgery, Queen Square, London, United Kingdom
Interventional Neuroradiology Unit – Monash Imaging, Monash Health, Melbourne, Victoria, Australia
Department of Imaging, Monash University, Melbourne, Australia
School of Medicine, Faculty of Health, Deakin University, Waurn Ponds, Victoria, Australia
Issue Date: 22-Nov-2017 2017-11-22
Publication information: World Neurosurgery 2017; online first: 22 November
Abstract: OBJECTIVE: Selection of patients with acute ischaemic stroke (AIS) for endovascular thrombectomy (EVT) is complex and time-critical. The benefits of EVT are well established for patients with small core infarcts. The aim of this study was to compare clinical outcomes of EVT in patients with larger established infarcts (ASPECTS ≤6), with a smaller infarct group (ASPECTS 7-10). METHODS: 355 patients with AIS due to large vessel occlusion (LVO) who underwent EVT were included. ASPECTS was assigned to baseline non-contrast CT and collateral perfusion scores to multiphase CT angiography. Baseline stroke severity, collateral grading, and clinical outcome data (complication rate, symptomatic intracranial haemorrhage and 90-day mRS) between patients with borderline (≤6) and high (7-10) ASPECTS were compared. RESULTS: Thirty-four (10%) had borderline ASPECTS. Overall, there was no difference in the rate of good clinical outcome (37% vs 46%, p=0.852), symptomatic intracerebral haemorrhage (9% vs 9%, p=0.984) or mortality (20% vs 22%, p=0.818) between patients with a borderline ASPECTS and high ASPECTS at 90 days. This was on the background of no significant difference in collateral perfusion grade. CONCLUSIONS: This study identifies similar clinical benefit of EVT in acute LVO stroke patients with borderline and high ASPECTS.
DOI: 10.1016/j.wneu.2017.11.068
PubMed URL:
Type: Journal Article
Subjects: ASPECTS
Acute ischaemic Stroke
Collateral circulation
Endovascular thrombectomy
Interventional neuroradiology
Appears in Collections:Journal articles

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