Impact of aspects subscores on outcomes in patients with large core ischemic stroke following endovascular thrombectomy

초록

Background and aims: The impact of Alberta Stroke Program Early CT Score (ASPECTS) subscores on functional outcomes in the patients with large core ischemic stroke following endovascular thrombectmy (EVT) has not been fully established. This study investigates the relationship between ASPECTS subscores and functional outcomes in patients undergoing EVT for large core ischemic stroke. Methods: We retrospectively analyzed the patients with large core ischemic stroke (ASPECTS ≤5) who underwent EVT. Baseline demographics, imaging findings, and procedural variables were collected. Multivariable logistic regression was performed to identify factors associated with outcomes. Results: Among 295 patients, mean age was 69.5, 62.4 % were male, mean ASPECTS was 3.64 and 49.2 % had mRS ≥ 4 at 3 months after the stroke. Among ASPECTS subscores, IC was significantly associated with mRS ≥ 4 (Odds ratio [95 % Confidence interval] = 3.01 [1.45–6.24], p = 0.003), mRS ≥ 3 (2.24 [1.03–4.87], p = 0.042), and ordinal mRS shift (2.03 [1.19–3.46], p = 0.009). Among the patients with initial IC lesions, the patients with IC reversal on follow-up imaging had significantly lower rate of mRS ≥ 4 compared to those without IC reversal (38.1 % vs. 80.0 %, p < 0.001). Conclusions: The involvement of the IC was associated with poor functional outcomes after EVT for large core ischemic stroke, likely because IC lesions are related to motor function and extensive basal ganglia infarction.