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Title: Borderline Alberta Stroke Programme Early CT Score Patients with Acute Ischemic 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, Department of Radiology, Austin Health, Heidelberg, Victoria, Australia
School of Medicine, Faculty of Health, Deakin University, Victoria, Australia
NeuroSpine Surgery Research Group, Prince of Wales Private Hospital, Sydney, Australia
Lysholm Department of Neuroradiology, The National Hospital for Neurology and Neurosurgery, London, United Kingdom
South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
University of Adelaide, Adelaide, South Australia, Australia
Interventional Neuroradiology Unit, Monash Imaging, Monash Health, Melbourne, Australia
Department of Imaging, Monash University, Melbourne, Australia
Issue Date: Feb-2018 2017
Publication information: World Neurosurgery 2018-02; 110: e653-e658
Abstract: Selection of patients with acute ischemic stroke for endovascular thrombectomy (EVT) is complex and time-critical. 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 (Alberta Stroke Programme Early CT Score [ASPECTS] ≤6) with patients with smaller infarcts (ASPECTS 7-10). The study included 355 patients with acute ischemic stroke due to large vessel occlusion who underwent EVT. ASPECTS was assigned to baseline noncontrast computed tomography, and collateral perfusion scores were assigned to multiphase computed tomography angiography. Baseline stroke severity, collateral grading, and clinical outcome data (complication rate, symptomatic intracranial hemorrhage and 90-day modified Rankin Scale score) were compared between patients with borderline (≤6) and high (7-10) ASPECTS. There were 34 (10%) patients with borderline ASPECTS. There was no difference in rate of good clinical outcome (37% vs. 46%, P = 0.852), symptomatic intracerebral hemorrhage (9% vs. 9%, P = 0.984), or mortality (20% vs. 22%, P = 0.818) between patients with borderline ASPECTS and high ASPECTS at 90 days. Moreover, there was no significant difference in collateral perfusion grade. This study identifies similar clinical benefit of EVT in patients with acute large vessel occlusion stroke with borderline ASPECTS and high ASPECTS.
DOI: 10.1016/j.wneu.2017.11.068
PubMed URL: 29175568
Type: Journal Article
Subjects: ASPECTS
Acute Ischaemic Stroke
Collateral circulation
Endovascular thrombectomy
Interventional neuroradiology
Appears in Collections:Journal articles

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