Outcomes of Mechanical Thrombectomy for Patients With Stroke Presenting With Low Alberta Stroke Program Early Computed Tomography Score in the Early and Extended Window

• DOI: 10.1001/jamanetworkopen.2021.37708
• Publication Date: 2021-12-08T16:01:38Z
• Authors: Eyad Almallouhi; Sami Al Kasab; Zachary Hubbard; Eric C. Bass; Guilherme Porto; Ali Alawieh; Reda Chalhoub; Pascal M. Jabbour; Robert M. Starke; Stacey Q. Wolfe; Adam S. Arthur; Edgar Samaniego; Ilko Maier; Brian M. Howard; Ansaar Rai; Min S. Park; Justin Mascitelli; Marios Psychogios; Reade De Leacy; Travis Dumont; Michael R. Levitt; Adam Polifka; Joshua Osbun; Roberto Crosa; Joon-Tae Kim; Walter Casagrande; Shinichi Yoshimura; Charles Matouk; Peter T Kan; Richard W Williamson; Benjamin Gory; Maxim Mokin; Isabel Fragata; Osama Zaidat; Albert J. Yoo; Alejandro M. Spiotta; ; Dileep R. Yavagal; Eric C. Peterson; J Mocco; Johanna T. Fifi; Christopher P. Ke...; Mohammad El-Ghanem; Kyle M. Fargen; Patrick A. Brown; Stavropoula I. Tj...; M. Reid Gooch; Nabeel A. Herial; Brian L. Hoh; Nohra Chalouhi; Nitin Goyal; Daniel A. Hoit; Fernanda Rodrigue...; Jan Liman; Kaustubh S. Limaye; Edgar A. Samaniego; Charles M. Cawley; Gustavo Pradilla; Brian M. Howard; Waldo R. Guerrero; João C. Reis; Russell Cerejo; Alex Brehm
• Keywords: Stroke

Limited data are available about the outcomes of mechanical thrombectomy (MT) for real-world patients with stroke presenting a large core infarct.To investigate safety and effectiveness MT vessel occlusion an Alberta Stroke Program Early Computed Tomography Score (ASPECTS) 2 to 5.This retrospective cohort study used from Thrombectomy Aneurysm Registry (STAR), which combines prospectively maintained databases 28 thrombectomy-capable centers in US, Europe, Asia. The included 2345 internal carotid artery or M1 segment middle cerebral January 1, 2016, December 31, 2020. Patients were followed up 90 days after intervention. ASPECTS is 10-point scoring system based on extent early ischemic changes baseline noncontrasted computed tomography scan, score 10 indicating normal 0 all regions score.All underwent one centers.A multivariable regression model was assess factors associated favorable 90-day outcome (modified Rankin Scale 0-2), including interaction terms between 5 receiving extended window (6-24 hours symptom onset).A total who (1175 women [50.1%]; median age, 72 years [IQR, 60-80 years]; 2132 [90.9%] had ≥6, 213 [9.1%] 2-5). At days, 47 (22.1%) modified (25.6% [45 176] successful recanalization [modified Thrombolysis Cerebral Ischemia ≥2B] vs 5.4% [2 37] unsuccessful recanalization; P = .007). Having low (odds ratio, 0.60; 95% CI, 0.38-0.85; .002) 0.69; 0.55-0.88; .001) worse controlling potential confounders, without significant these (P .64).In this study, more than 1 achieved functional independence MT. A nearly times likely recanalization. association did not differ window.