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Comparative Outcomes of Mechanical Thrombectomy in Acute Ischemic Stroke Patients with ASPECTS 2-3 vs. 4-5.
Orscelik, Atakan; Matsukawa, Hidetoshi; Elawady, Sameh Samir; Sowlat, Mohamed Mahdi; Cunningham, Conor; Zandpazandi, Sara; Kasem, Rahim Abo; Maier, Ilko; Jabbour, Pascal; Kim, Joon-Tae; Wolfe, Stacey Quintero; Rai, Ansaar; Starke, Robert M; Psychogios, Marios-Nikos; Shaban, Amir; Goyal, Nitin; Yoshimura, Shinichi; Cuellar, Hugo; Howard, Brian; Alawieh, Ali; Romano, Daniele G; Tanweer, Omar; Mascitelli, Justin; Fragata, Isabel; Polifka, Adam; Osbun, Joshua; Crosa, Roberto; Matouk, Charles; Park, Min S; Levitt, Michael R; Brinjikji, Waleed; Moss, Mark; Dumont, Travis; Williamson, Richard; Navia, Pedro; Kan, Peter; De Leacy, Reade; Chowdhry, Shakeel; Ezzeldin, Mohamad; Spiotta, Alejandro M; Kasab, Sami Al.
Afiliação
  • Orscelik A; Department of Neurosurgery, Division of Neuroendovascular Surgery, Medical University of South Carolina, Charleston, SC, USA. Electronic address: atakanorscelik@gmail.com.
  • Matsukawa H; Department of Neurosurgery, Division of Neuroendovascular Surgery, Medical University of South Carolina, Charleston, SC, USA; Department of Neurosurgery, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan. Electronic address: nowornever1982@gmail.com.
  • Elawady SS; Department of Neurosurgery, Division of Neuroendovascular Surgery, Medical University of South Carolina, Charleston, SC, USA. Electronic address: elgahsh@musc.edu.
  • Sowlat MM; Department of Neurosurgery, Division of Neuroendovascular Surgery, Medical University of South Carolina, Charleston, SC, USA. Electronic address: sowlat@musc.edu.
  • Cunningham C; Department of Neurosurgery, Division of Neuroendovascular Surgery, Medical University of South Carolina, Charleston, SC, USA. Electronic address: coc302@musc.edu.
  • Zandpazandi S; Department of Neurosurgery, Division of Neuroendovascular Surgery, Medical University of South Carolina, Charleston, SC, USA. Electronic address: zandpaza@musc.edu.
  • Kasem RA; Department of Neurosurgery, Division of Neuroendovascular Surgery, Medical University of South Carolina, Charleston, SC, USA. Electronic address: abokasem@musc.edu.
  • Maier I; Department of Neurology, University Medicine Goettingen, Goettingen, Germany. Electronic address: ilko.maier@med.uni-goettingen.de.
  • Jabbour P; Department of Neurosurgery, Thomas Jefferson University, Philadelphia, PA, USA. Electronic address: pascal.jabbour@jefferson.edu.
  • Kim JT; Department of Neurology, Chonnam National University Hospital, Gwangju, Korea. Electronic address: alldelight2@chonnam.ac.kr.
  • Wolfe SQ; Department of Neurosurgery, Wake Forest School of Medicine, Winston-Salem, NC, USA. Electronic address: sqwolfe@wakehealth.edu.
  • Rai A; Department of Radiology, West Virginia University, Morgantown, WV, USA. Electronic address: raia@wvumedicine.org.
  • Starke RM; Department of Neurosurgery, University of Miami Miller School of Medicine, Miami, Florida, USA. Electronic address: rstarke@med.miami.edu.
  • Psychogios MN; Department of Neuroradiology, Clinic of Radiology and Nuclear Medicine, University of Basel, Basel, Switzerland. Electronic address: marios.psychogios@usb.ch.
  • Shaban A; Department of Neurology, University of Iowa, Iowa City, IA, USA. Electronic address: amir-shaban@uiowa.edu.
  • Goyal N; Department of Neurosurgery, University of Tennessee Health Science Center/Semmes-Murphey Foundation, Memphis, TN, USA. Electronic address: ngoyal@semmes-murphey.com.
  • Yoshimura S; Department of Neurosurgery, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan. Electronic address: hyogoneuro@yahoo.co.jp.
  • Cuellar H; Department of Neurosurgery, Louisiana State University Health, Shreveport, LA, USA. Electronic address: hcuell@lsuhsc.edu.
  • Howard B; Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia, USA. Electronic address: brian.howard@emory.edu.
  • Alawieh A; Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia, USA. Electronic address: ali.alawieh1@gmail.com.
  • Romano DG; Department of Neuroradiology, University Hospital San Giovanni di Dio e Ruggi d'Aragona, University of Salerno, Salerno, Italy. Electronic address: dr.80@live.it.
  • Tanweer O; Department of Neurosurgery, Baylor College of Medicine, Houston, TX, USA. Electronic address: omar.tanweer@bcm.edu.
  • Mascitelli J; Department of Neurosurgery, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA. Electronic address: mascitelli@uthscsa.edu.
  • Fragata I; Department of Neuroradiology, Centro Hospitalar Universitario de Lisboa Central, Lisboa, Portugal. Electronic address: isabelfragata@gmail.com.
  • Polifka A; Department of Neurosurgery, University of Florida, Gainesville, Florida, USA. Electronic address: adam.polifka@neurosurgery.ufl.edu.
  • Osbun J; Department of Neurological Surgery, Washington University in St. Louis, St. Louis, MO, USA. Electronic address: josbun@wustl.edu.
  • Crosa R; Department of Neurosurgery, Endovascular Neurological Center, Medica Uruguaya, Montevideo, Uruguay. Electronic address: rocrossa@gmail.com.
  • Matouk C; Department of Neurosurgery, Yale School of Medicine, New Haven, CT, USA. Electronic address: charles.matouk@yale.edu.
  • Park MS; Department of Neurosurgery, University of Virginia, Charlottesville, VA, USA. Electronic address: mp2tq@uvahealth.org.
  • Levitt MR; Department of Neurosurgery, University of Washington School of Medicine, Seattle, WA, USA. Electronic address: mlevitt@uw.edu.
  • Brinjikji W; Department of Radiology, Mayo Clinic, Rochester, MN, USA. Electronic address: brinjikji.waleed@mayo.edu.
  • Moss M; Department of Neuroradiology, Washington Regional Medical Center, Fayetteville, AZ, USA. Electronic address: m2moss@wregional.com.
  • Dumont T; Department of Neurosurgery, University of Arizona, Tucson, AZ, USA. Electronic address: tdumont@surgery.arizona.edu.
  • Williamson R; Department of Neurosurgery, Allegheny Health Network, Pittsburgh, PA, USA. Electronic address: richard.williamson@ahn.org.
  • Navia P; Department of Neuroradiology, Hospital Universitario La Paz, Madrid, Spain. Electronic address: pnavia1@gmail.com.
  • Kan P; Department of Neurosurgery, University of Texas Medical Branch at Galveston, Galveston, TX, USA. Electronic address: ptkan@utmb.edu.
  • De Leacy R; Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA. Electronic address: reade.deleacy@mountsinai.org.
  • Chowdhry S; Department of Neurosurgery, NorthShore University Health System, Chicago, IL, USA. Electronic address: schowdhry@northshore.org.
  • Ezzeldin M; Department of Clinical Sciences, University of Houston, HCA Houston Healthcare Kingwood, Houston, TX, USA. Electronic address: mohamadezzeldin@hotmail.com.
  • Spiotta AM; Department of Neurosurgery, Division of Neuroendovascular Surgery, Medical University of South Carolina, Charleston, SC, USA. Electronic address: spiotta@musc.edu.
  • Kasab SA; Department of Neurosurgery, Division of Neuroendovascular Surgery, Medical University of South Carolina, Charleston, SC, USA. Electronic address: alkasab@musc.edu.
J Stroke Cerebrovasc Dis ; 33(2): 107528, 2024 Feb.
Article em En | MEDLINE | ID: mdl-38134550
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.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Isquemia Encefálica / Acidente Vascular Cerebral / AVC Isquêmico Limite: Humans País como assunto: America do norte Idioma: En Ano de publicação: 2024 Tipo de documento: Article
Texto completo
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Isquemia Encefálica / Acidente Vascular Cerebral / AVC Isquêmico Limite: Humans País como assunto: America do norte Idioma: En Ano de publicação: 2024 Tipo de documento: Article