Comparative Outcomes of Mechanical Thrombectomy in Acute Ischemic Stroke Patients with ASPECTS 2-3 vs. 4-5.

Authors

• Atakan Orscelik
• Hidetoshi Matsukawa
• Sameh Samir Elawady
• Mohamed Mahdi Sowlat
• Conor Cunningham
• Sara Zandpazandi
• Rahim Abo Kasem
• Ilko Maier
• Pascal Jabbour
• Joon-Tae Kim
• Stacey Quintero Wolfe
• Ansaar Rai
• Robert M Starke
• Marios-Nikos Psychogios
• Amir Shaban
• Nitin Goyal
• Shinichi Yoshimura
• Hugo Cuellar
• Brian Howard
• Ali Alawieh
• Daniele G Romano
• Omar Tanweer
• Justin Mascitelli
• Isabel Fragata
• Adam Polifka
• Joshua Osbun
• Roberto Crosa
• Charles Matouk
• Min S Park
• Michael R Levitt
• Waleed Brinjikji
• Mark Moss
• Travis Dumont
• Richard Williamson
• Pedro Navia
• Peter Kan
• Reade De Leacy
• Shakeel Chowdhry
• Mohamad Ezzeldin
• Alejandro M Spiotta
• Sami Al Kasab

Publication/Presentation Date

2-1-2024

Abstract

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.

Volume

33

Issue

2

First Page

107528

Last Page

107528

ISSN

1532-8511

Published In/Presented At

Orscelik, A., Matsukawa, H., Elawady, S. S., Sowlat, M. M., Cunningham, C., Zandpazandi, S., Kasem, R. A., Maier, I., Jabbour, P., Kim, J. T., Wolfe, S. Q., Rai, A., Starke, R. M., Psychogios, M. N., Shaban, A., Goyal, N., Yoshimura, S., Cuellar, H., Howard, B., Alawieh, A., … STAR Collaborators (2024). Comparative Outcomes of Mechanical Thrombectomy in Acute Ischemic Stroke Patients with ASPECTS 2-3 vs. 4-5. Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association, 33(2), 107528. https://doi.org/10.1016/j.jstrokecerebrovasdis.2023.107528

Disciplines

Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods

PubMedID

38134550

Department(s)

Administration and Leadership

Document Type

Article