• Peng-Fei Xing, Yong-Wei Zhang, Lei Zhang, Zi-Fu Li, Hong-Jian Shen, Yong-Xin Zhang, He Li, Wei-Long Hua, Pei Liu, Peng Liu, Peng-Fei Yang, Bo Hong, Ben-Qiang Deng, and Jian-Min Liu.
• Department of Neurology, Changhai Hospital, Naval Medical University, Shanghai, China.
• Neurosurgery. 2021 Feb 16; 88 (3): 612-618.

BackgroundPatients with large vessel occlusion and noncontrast computed tomography (CT) Alberta Stroke Program Early CT Score (ASPECTS) <6 may benefit from endovascular treatment (EVT). There is uncertainty about who will benefit from it.ObjectiveTo explore the predicting factors for good outcome in patients with ASPECTS <6 treated with EVT.MethodsWe retrospectively reviewed 60 patients with ASPECTS <6 treated with EVT in our center between March 2018 and June 2019. Patients were divided into 2 groups because of the modified Rankin Score (mRS) at 90 d: good outcome group (mRS 0-2) and poor outcome group (mRS ≥3). Baseline and procedural characteristics were collected for unilateral variate and multivariate regression analyses to explore the influent variates for good outcome.ResultsGood outcome (mRS 0-2) was achieved in 24 (40%) patients after EVT and mortality was 20% for 90 d. Compared with the poor outcome group, higher baseline cortical ASPECTS (c-ASPECTS), lower intracranial hemorrhage, and malignant brain edema after thrombectomy were noted in the good outcome group (all P < .01). Multivariate logistic regression showed that only baseline c-ASPECTS (≥3) was positive factor for good outcome (odds ratio = 4.29; 95% CI, 1.21-15.20; P = .024). The receiver operating characteristics curve indicated a moderate value of c-ASPECTS for predicting good outcome, with the area under receiver operating characteristics curve 0.70 (95% CI, 0.56-0.83; P = .011).ConclusionHigher baseline c-ASPECTS was a predictor for good clinical outcome in patients with ASPECTS <6 treated with EVT, which could be helpful to treatment decision.Copyright © 2020 by the Congress of Neurological Surgeons.

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