Abstract 3873: Relationship Between Alberta Stroke Program Early CT Score (ASPECTS) And Outcomes In Intra-arterial Treatment Of Acute Ischemic Stroke
Background and Purpose: Identification of early ischemic stroke is instrumental in rapidly triaging patients who may benefit from revascularization. We sought to understand the relationship between baseline ASPECT scores and outcomes in patients who underwent intra-arterial thrombolysis.
Methods: Retrospective review of a prospectively maintained database of acute ischemic strokes at the University of Pittsburgh Medical Center during the time period of 2001-2011. CT-ASPECT scores were prospectively scored by treating physicians. The following additional factors were considered: age, NIHSS, time from last seen well (TLSW) to angiography, good vascular flow (TIMI score of 2 or 3), parenchymal hematoma (PH) formation and good clinical outcome (mRS score of 0-2 at 90 days).
Results: Of 322 patients included in the study, there was a significant correlation between ASPECT score and good clinical outcome when good vascular flow was achieved. Table 1 and graph 1 summarizes the distribution of ASPECTS scores and corresponding rate of good TIMI flow and good clinical outcome along with other variables of interest.
Conclusions: A baseline ASPECT score of 7 or greater is predictive of a good clinical outcome, particularly when adequate recanalization is achieved. In contrast, patients with an ASPECT score of 6 or less had poor clinical outcomes, particularly when recanalization was not achieved. These data support a paradigm in which CT ASPECT scores are used to define patients appropriate for endovascular treatement.
- © 2012 by American Heart Association, Inc.