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Can flat-detector CT after successful endovascular treatment predict long-term outcome in patients with large vessel occlusion? An Alberta Stroke Programme Early CT Score–based study.
- Source :
- Neurological Sciences; Apr2023, Vol. 44 Issue 4, p1193-1200, 8p, 1 Black and White Photograph, 1 Diagram, 2 Charts, 3 Graphs
- Publication Year :
- 2023
-
Abstract
- Purpose: Recent studies postulate a high prognostic value of the Alberta Stroke Programme Early CT Score (ASPECTS) applied on non-contrast whole-brain flat-detector CT (FDCT) after successful endovascular treatment (EVT). The aim of this study was the evaluation of long-term patient outcome after endovascular treatment using postinterventional FDCT. Methods: Using a local database (Stroke Research Consortium in Northern Bavaria, STAMINA), 517 patients with successful endovascular treatment (modified Thrombolysis in Cerebral Infarction (mTICI) ≥ 2B) due to acute ischaemic stroke (AIS) and large vessel occlusion (LVO) of the anterior circulation were recruited retrospectively. In all cases, non-contrast FDCT after EVT was analysed with special focus at ASPECTS. These results were correlated with the functional outcome in long-term (modified Rankin Scale (mRS) shift from pre-stroke to 90 days after discharge). Results: A significant difference in FDCT-ASPECTS compared to the subgroup of favourable vs. unfavourable outcome (Δ mRS) (median ASPECTS 10 (10–9) vs. median ASPECTS 9 (10–7); p = 0,001) could be demonstrated. Multivariable regression analysis revealed FDCT-ASPECTS (OR 0.234, 95% CI − 0.102–0.008, p = 0.022) along with the NHISS at admission (OR 0.169, 95% CI 0.003–0.018, p = 0.008) as independent factors for a favourable outcome. Cut-off point for a favourable outcome (Δ mRS) was identified at an ASPECTS ≥ 8 (sensitivity 90.6%, specificity 35%). Conclusion: For patients with LVO and successful EVT, FDCT-ASPECTS was found to be highly reliable in predicting long-term outcome. [ABSTRACT FROM AUTHOR]
- Subjects :
- ENDOVASCULAR surgery
STROKE
ISCHEMIC stroke
CEREBRAL infarction
PROGNOSIS
Subjects
Details
- Language :
- English
- ISSN :
- 15901874
- Volume :
- 44
- Issue :
- 4
- Database :
- Complementary Index
- Journal :
- Neurological Sciences
- Publication Type :
- Academic Journal
- Accession number :
- 162507848
- Full Text :
- https://doi.org/10.1007/s10072-022-06511-z