Favorable revascularization therapy in patients with ASPECTS ≤ 5 on DWI in anterior circulation stroke

Journal of Neurointerventional Surgery
I MourandV Costalat

Abstract

A low baseline Alberta Stroke Programme Early CT Score (ASPECTS) is strongly associated with low rates of favorable outcome in patients with acute stroke. To evaluate the efficacy and safety of revascularization therapy in patient with ASPECTS ≤5 in anterior circulation infarct. We retrospectively analyzed 108 consecutive patients presenting low ASPECTS on diffusion-weighted imaging. Sixty patients were treated by mechanical thrombectomy, including 34 patients who received simultaneously intravenous thrombolysis. A control group of 48 patients not eligible for reperfusion therapy gave us a perspective on the natural history. Clinical outcome was evaluated at 90 days using the modified Rankin Scale (mRS) score. Hemicraniectomy after malignant infarction, mortality, and symptomatic intracranial haemorrhage (sICH) were also reported. Thrombolysis in Cerebral Infarction 2b-3 was assessed in 75% of treated patients. Reperfusion therapy led to significantly reduced disability (mRS score 0-2) at 90 days compared with the control group (30% vs 2.1%, p<0.001), hemicraniectomy (3.3% vs 22.9%, p=0.002), and death at 90 days (25% vs 47.9%, p=0.01). The sICH level was similar in treated patients and in the control group (p=0.78). Patients a...Continue Reading

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Dec 21, 2017·Journal of Neurointerventional Surgery·Felipe C AlbuquerqueDavid Fiorella
Sep 20, 2018·Journal of Neuroimaging : Official Journal of the American Society of Neuroimaging·Marta Olive-GadeaMarta Rubiera
Jan 11, 2019·Journal of Cerebral Blood Flow and Metabolism : Official Journal of the International Society of Cerebral Blood Flow and Metabolism·Gabriel BroocksAndre Kemmling
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Jan 6, 2019·Journal of Neurointerventional Surgery·Maxim MokinUNKNOWN Society of NeuroInterventional Surgery
Nov 6, 2018·Journal of Neurointerventional Surgery·Ali AlawiehAlejandro M Spiotta
Mar 1, 2019·Journal of Neurointerventional Surgery·Arturo RenúXabier Urra
Sep 9, 2019·Acta Neurologica Scandinavica·Xuefei LiXiang Luo
Jul 28, 2019·Journal of Neurointerventional Surgery·Eric S SussmanJeremy J Heit
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