Thrombectomy for Acute Stroke with a Large Ischemic Core

A secondary analysis shows potential benefit in patients with an ASPECTS of 4 to 5, but validation is needed.

Endovascular thrombectomy (EVT) improves neurologic outcome for select patients with a large-vessel occlusion. Current guidelines state that patients should not have a large infarct core before EVT. However, the exact size cutoff is unknown. These investigators previously reported on a randomized trial of EVT for large-infarct ischemic stroke at 45 centers in Japan. This secondary analysis compared outcomes according to Alberta Stroke Program Early Computed Tomography Score (ASPECTS), which is based on computed tomography or MRI and ranges from 0 to 10, with lower scores indicating larger infarct cores. They compared patients with an ASPECTS of 4–5 versus 3 or less. The primary outcome was modified Rankin Scale score of 0 to 3 at 90 days.

Am…

Reviewing Author

Seemant Chaturvedi, MD

Disclosures

Consultant/Advisory BoardBayer Pharmaceuticals; Novartis

Grant/Research SupportNational Institute of Neurological Disorders and Stroke

Editorial BoardsNeurology; Stroke

Seemant Chaturvedi, MD

Disclosures

Consultant/Advisory BoardBayer Pharmaceuticals; Novartis

Grant/Research SupportNational Institute of Neurological Disorders and Stroke

Editorial BoardsNeurology; Stroke

Thrombectomy for Acute Stroke with a Large Ischemic Core

Topics

Reviewing Author