학술논문
Abstract TMP63: Predictors And Clinical Impact Of ASPECTS Evolution After Successful Reperfusion With Endovascular Therapy: Insight From The ETIS Registry
Document Type
Article
Author
Anadani, Mohammad; JANUEL, ANNE CHRISTINE; Finitsis, Stephanos N; Clarençon, Frédéric; Richard, Sébastien; Marnat, Gaultier; bourcier, romain; Sibon, Igor; Dargazanli, Cyril; Arquizan, Caroline; BLANC, RAPHAEL; LAPERGUE, Bertrand; Consoli, Arturo; Eugène, François; vannier, stephane; Caroff, Jildaz; denier, christian; BOULANGER, Marion; Gauberti, Maxime; Rouchaud, Aymeric; Macian, Francisco; Rosso, Charlotte; ben Hassen, wagih; TURC, Guillaume; ozkul-wermester, ozlem; PAPAGIANNAKI, CHRYSANTHI; Albucher, Jean Francois; LE BRAS, Anthony; Evain, Sarah; wolff, valerie; Pop, Raoul; Timsit, Serge; Gentric, Jean-Christophe; Bourdain, Frédéric; Veunac, Louis; de Havenon, Adam H; Maier, Benjamin; Gory, Benjamin
Source
Stroke (Ovid); February 2022, Vol. 53 Issue: Supplement 1 pATMP63-ATMP63, 1p
Subject
Language
ISSN
00392499; 15244628
Abstract
Background:Alberta Stroke Program Early CT scan Score (ASPECTS) is a reliable imaging biomarker of infarct extension in patients with large vessel occlusions. ASPECTS evolution, a surrogate of infarct expansion, is an important predictor of functional and safety outcomes after endovascular therapy (EVT). In this study, we aimed to identify the predictors of ASPECTS evolution after successful reperfusion and the association between ASPECTS evolution and outcomes of EVT.Methods:We used data from the ongoing prospective multicenter Endovascular Treatment in Ischemic Stroke (ETIS) registry (NCT03776877). For the purpose of this study, we enrolled patients with anterior circulation LVO treated with EVT and achieved successful reperfusion (mTICI 2b-3). Additional inclusion criteria included 1) the availability of ASPECTS score on admission and at 24 hours after EVT 2) ASPECTS was assessed on the same imaging technique (i.e MRI or CT) on admission and at 24 hours. We considered 2 or more points decrease in ASPECTS as a significant ASPECTS change. Multivariable logistic regression analyses were used to identify the predictors of ASPECT evolution and to study the association between ASPECTS evolution and outcomes.Results:We included a total of 1161 patients, of whom 978 (84%) patients had at least 2 points decrease in ASPECTS score. Worsening ASPECTS score was associated with higher odds of poor functional outcome (90-day mRS 3-6), mortality, and symptomatic intracerebral hemorrhage. Admission ASPECTS, NIHSS, blood glucose, location of occlusion, final mTICI score, total number of attempts and procedure time emerged as predictors of ASPECTS evolution.Conclusion:ASPECTS evolution is a strong predictor of clinical and safety outcomes after successful reperfusion with EVT.