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Low (0-5) Alberta Stroke Program Early Computed Tomography Score on admission predictive of worse functional outcome after mechanical thrombectomy for anterior circulation large vessel occlusion.
Li, Jinze; Duan, Jinfeng; Zhang, Luojin; Chen, Jingshu; Duan, Yang; Yang, Benqiang.
Afiliación
  • Li J; Jinzhou Medical University General Hospital of Northern Theater Command Postgraduate Training Base, Shenyang, China.
  • Duan J; Center for Neuroimaging, Department of Radiology, General Hospital of Northern Theater Command, Shenyang, China.
  • Zhang L; Department of Surgery, General Hospital of Northern Theater Command, Shenyang, China.
  • Chen J; Center for Neuroimaging, Department of Radiology, General Hospital of Northern Theater Command, Shenyang, China.
  • Duan Y; Dalian Medical University General Hospital of Northern Theater Command Postgraduate Training Base, Shenyang, China.
  • Yang B; Department of Radiology, General Hospital of Northern Theater Command, 83 Wenhua Road, Shenhe District, Shenyang, 110016, Liaoning, China.
Eur J Med Res ; 28(1): 266, 2023 Aug 04.
Article en En | MEDLINE | ID: mdl-37542346
BACKGROUND AND PURPOSE: We examined functional outcomes of mechanical thrombectomy (MT) procedures following anterior circulation large vessel occlusion (ACLVO)-related acute ischemic strokes (AIS). Results were based on admission non-contrast computed tomography (NCCT) studies, using the Alberta Stroke Program Early Computed Tomography Score (ASPECTS) as standard metric. METHODS: Qualifying subjects were consecutive patients (N = 343) at a single center undergoing MT for ACLVO-related AIS. Each was grouped according to ASPECTS status on admission, determined from NCCT images by two physicians. Primary clinical endpoint was functional independence, assessed via modified Rankin Scale (mRS) at 90 days. Secondary endpoints were vessel recanalization (i.e., modified Thrombolysis in Cerebral Infarction [mTICI] score), symptomatic intracranial hemorrhage (sICH), and mortality. RESULTS: In this study population (mean age, 63.6 ± 12.6 years; women, 30.3%; median baseline National Institute of Health Stroke Scale [NIHSS] score, 15.2 ± 4.5), patients were stratified by ASPECTS tier at presentation, either 0-5 (n = 50) or 6-10 (n = 293). Multivariate logistic regression showed a relation between ASPECTS values ≤ 5 and lesser chance of 90-day functional improvement (OR = 2.309, 95% confidence interval [CI] 1.012-5.271; p = 0.047), once adjusted for age, baseline NIHSS score, diabetes mellitus, HbA1c concentration, D-dimer level, occlusive location, numbers of device passes, and successful recanalization. CONCLUSIONS: ASPECTS values ≤ 5 correspond with worse long-term functional improvement (mRS scores > 2) in patients undergoing MT for ACLVO-related AIS. Other independent determinants of functional outcomes after MT are age, baseline NIHSS score, HbA1c concentration, and successful recanalization.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Accidente Cerebrovascular Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Female / Humans / Middle aged País/Región como asunto: America do norte Idioma: En Revista: Eur J Med Res Asunto de la revista: MEDICINA Año: 2023 Tipo del documento: Article País de afiliación: China Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Accidente Cerebrovascular Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Female / Humans / Middle aged País/Región como asunto: America do norte Idioma: En Revista: Eur J Med Res Asunto de la revista: MEDICINA Año: 2023 Tipo del documento: Article País de afiliación: China Pais de publicación: Reino Unido