Article Commentary: “Mechanical Thrombectomy in Ischemic Stroke Patients With Alberta Stroke Program Early Computed Tomography Score 0–5”
Mausaminben Hathidara, MD
Kaesmacher J, Chaloulos-Iakovidis P, Panos L, Mordasini P, Michel P, Hajdu SD, et al. Mechanical Thrombectomy in Ischemic Stroke Patients With Alberta Stroke Program Early Computed Tomography Score 0–5. Stroke. 2019;50:880–888.
Mechanical thrombectomy (MT) for patients with large vessel occlusion of anterior circulation, presenting within 6 hours from symptoms onset and ASPECT score 6-10, is the standard of treatment and recommended by the American Stroke Association. However, very limited data is available regarding safety and efficacy for such treatment modalities for patients with ASPECT score 0-5. This multicenter retrospective non-randomized study analyzed MT outcome for patients with ASPECT score 0-5 at 90 days. Primary outcome of the study was favorable outcome (mRS 0-3) at 90 days and secondary outcome was mRS 0-2 at 90 days, major early neurological improvement (defined as change in NIHSS >8 points, 24 hr NIHSS<1), all-cause mortality at 90 days and symptomatic intracerebral hemorrhage (sICH). 1532 patients who had confirmed anterior circulation LVO including intracranial ICA, ICA T/L, M1, M2, tandem occlusion and ASPECT score available on either CT (910/1532) or MRI (600/1532) were included in the final analysis. TICI score and ASPECT score were determined by an independent research fellow at each site. 90 days mRS was obtained by a physician or trained certified nurse. NIHSS at admission and 24 hours was performed by a stroke neurologist.