Association of pretreatment ASPECTS scores with tPA-induced arterial recanalization in acute middle cerebral artery occlusion

Journal of Neuroimaging : Official Journal of the American Society of Neuroimaging
Georgios TsivgoulisCLOTBUST Investigators

Abstract

The Alberta Stroke Program Early CT-Score (ASPECTS) assesses early ischemic changes within the middle cerebral artery (MCA) and predicts poor outcome and increased risk for thrombolysis-related symptomatic ICH. We evaluated the potential relationship between pretreatment ASPECTS and tPA-induced recanalization in patients with MCA occlusions. Consecutive patients with acute ischemic stroke due to MCA occlusion were treated with standard IV-tPA and assessed with transcranial Doppler (TCD) for arterial recanalization. Early recanalization was determined with previously validated Thrombolysis in Brain Ischemia (TIBI) flow-grading system at 120 minutes after tPA-bolus. All pretreatment CT-scans were prospectively scored by trained investigators blinded to TCD findings. Functional outcome at 3 months was evaluated using the modified Rankin Scale (mRS). IV-tPA was administered in 192 patients (mean age 68 +/- 14 years, median NIHSS-score 17). Patients with complete recanalization (n= 51) had higher median pretreatment ASPECTS (10, interquartile range 2) than patients with incomplete or absent recanalization (n= 141; median ASPECTS 9, interquartile range 3, P= .034 Mann-Whitney U-test). An ASPECTS < or =6 was documented in 4% and 17% o...Continue Reading

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Citations

Jan 15, 2011·Stroke; a Journal of Cerebral Circulation·Oh Young BangDavid S Liebeskind
Sep 6, 2013·Japanese Journal of Radiology·Warinthorn PhuttharakSomsak Tiamkao
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Aug 31, 2016·Journal of Neuroimaging : Official Journal of the American Society of Neuroimaging·Benjamin Yong-Qiang TanLeonard Leong-Litt Yeo
Mar 5, 2011·Stroke; a Journal of Cerebral Circulation·Georgios TsivgoulisAndrei V Alexandrov
Jul 25, 2009·Stroke; a Journal of Cerebral Circulation·Sabareesh K NatarajanElad I Levy

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