RT Journal Article
SR Electronic
T1 Association between ASPECTS region of infarction and clinical outcome in non-acute large vessel occlusion ischaemic stroke after endovascular recanalisation
JF Stroke and Vascular Neurology
JO Stroke Vasc Neurol
FD BMJ Publishing Group Ltd
SP svn-2024-003355
DO 10.1136/svn-2024-003355
A1 Lu, Jialiang
A1 Lu, Ziwei
A1 Li, Ye
A1 Li, Fangcun
A1 Feng, Yuxuan
A1 Dang, Meijuan
A1 Yang, Yang
A1 Tang, Fan
A1 Li, Tao
A1 Zhao, Lili
A1 Jian, Yating
A1 Wang, Xiaoya
A1 Zhang, Lei
A1 Fan, Hong
A1 Zhang, Guilian
YR 2024
UL http://svn.bmj.com/content/early/2024/09/11/svn-2024-003355.abstract
AB Purpose This study retrospectively investigated whether infarction in specific Alberta Stroke Program Early CT Score (ASPECTS) regions is associated with clinical outcome in patients with symptomatic non-acute internal carotid or middle cerebral artery occlusion who underwent endovascular recanalisation (ER).Methods Preoperative ASPECTS and region of infarction were recorded before recanalisation. Clinical outcome was evaluated 90 days after the procedure using the modified Rankin Scale; a score>2 was defined as poor outcome. Secondary outcomes included postprocedural cerebral oedema, intracranial haemorrhage (ICH) and symptomatic ICH.Results Among the 86 patients included, 90-day outcome was poor in 30 (34.9%) and 40 experienced cerebral oedema (46.5%). Multivariate logistic regression models showed that lenticular nucleus infarction (OR 19.61–26.00, p<0.05), admission diastolic blood pressure (OR 1.07–1.08, p<0.05), preprocedural National Institutes of Health Stroke Scale (OR 1.96–2.05, p<0.001) and haemorrhagic transformation (OR 14.99–18.81, p<0.05) were independent predictors of poor 90-day outcome. The area under the receiver operating characteristic curve for lenticular nucleus infarction as a predictor of poor outcome was 0.73. M2 region infarction (OR 26.07, p<0.001) and low American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology collateral circulation grade (OR 0.16, p=0.001) were independent predictors of postprocedural cerebral oedema. The area under the receiver operating characteristic curve for M2 region infarction as a predictor of cerebral oedema was 0.64. Region of infarction did not significantly differ between patients with and without postprocedural ICH or symptomatic ICH.Conclusions Lenticular nucleus and M2 region infarction were independent predictors of poor 90-day outcome and postprocedural cerebral oedema, respectively, in patients with non-acute anterior circulation large artery occlusion who underwent ER.Data are available on reasonable request. The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.