SKQAA3J7
type: UserItem
resource: Large ischemic core defined by visually assessed ASPECTS predicts functional outcomes comparably accurate to automated CT perfusion in the 6-24 h window
tagged: UserTag
  label: *Brain Ischemia/diagnostic imaging/therapy
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  label: *Ischemic Stroke/diagnostic imaging/therapy
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  label: *Tomography, X-Ray Computed/methods
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  label: Aged
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  label: Aged, 80 and over
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  label: Aspects
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  label: CT perfusion
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  label: Endovascular Procedures/methods
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  label: Female
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  label: GMDM received speaker honoraria from Medtronic. The remaining authors report no
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  label: Humans
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  label: Ischemic stroke
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  label: Male
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  label: Middle Aged
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  label: Predictive Value of Tests
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  label: Registries
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  label: Retrospective Studies
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  label: Roche Diagnostics. LHB received personal fees from Claret Medical and InnovHeart.
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  label: Treatment Outcome
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  label: and BMS/Pfizer, and in-kind contributions from BRAHMS Termofisher Scientific,
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  label: and USZ-foundation, and received honoraria and consulting fees from Astra Zeneca
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  label: conflicts of interest with respect to the research, authorship, and/or
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  label: conflicts relevant to this study.
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  label: endovascular treatment
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  label: funding form the Swiss National Science Foundation, the Swiss Heart Foundation,
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  label: holds stocks from Novartis, Roche, Alcon, and Johnson&Johnson. MK received
tagged: UserTag
  label: publication of this article: RS received personal grants from UCB-pharma and

Large ischemic core defined by visually assessed ASPECTS predicts functional outcomes comparably accurate to automated CT perfusion in the 6-24 h window
type: AcademicArticle
abstract: INTRODUCTION: Automated CT perfusion (aCTP) is commonly used to select patients with anterior circulation large vessel occlusion (aLVO) for endovascular treatment (EVT). The equivalence of visually assessed Non-contrast CT Alberta Stroke Program Early CT Scores (ASPECTS) and aCTP based selection in predicting favorable functional outcomes remains uncertain. PATIENTS AND METHODS: Retrospective multicenter study of adult aLVO patients from the Swiss Stroke Registry (2014-2021) treated with EVT or best medical treatment 6-24 h after stroke onset. We assessed ASPECTS on non-contrast CT visually and ischemic core volumes on aCTP, defining ASPECTS 0-5 and aCTP CBF < 30% volumes ⩾50 mL as large ischemic cores. We used logistic regression to explore the association between CT modalities and favorable functional outcomes (modified Rankin Scale [mRS] score shift toward lower categories) at 3 months. Receiver operating characteristic (ROC) curve analysis compared the predictive accuracy of visually assessed ASPECTS and aCTP ischemic core for favorable outcomes (mRS 0-2) at 3 months. RESULTS: Of 210 patients, 11.4% had ASPECTS 0-5, and 12.9% aCTP core volumes ⩾50 mL. Within the same model, ASPECTS but not aCTP core volumes were associated with favorable outcomes (ASPECTS: acOR 1.85, 95%CI 1.27-2.70, p = 0.001). The ROC curve analyses showed comparable diagnostic accuracy in predicting favorable functional outcomes (mRS 0-2) at 3 months (ROC areas: ASPECTS 0.80 [95%CI 0.74-0.86] vs aCTP core 0.79 [95%CI 0.72-0.85]). DISCUSSION AND CONCLUSION: In patients with aLVO, visually assessed ASPECTS showed at least comparable accuracy to automatically generated CTP core volumes in predicting functional outcomes at 3 months.
pages: 552-559
doi: 10.1177/23969873241286691
source: 39373098
creator: Person
author list: Person
is part of: Issue
  date: 2024-10-07
  volume: 10
  issue: 2
  is part of: Eur Stroke J
    type: Journal
    issn: 2396-9881 (Electronic) 2396-9873 (Print) 2396-9873 (Linking)

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