Abstract 132: The Capillary Index and ASPECT Scores Are Strong Predictors of Patient Outcome In The Interventional Management of Ischemic Strokes
Purpose: The angiography-based capillary index Score (CIS) has recently emerged as a potential tool for assessing viable tissue. Our study aimed at correlating the CIS with patient outcomes.
Materials and Methods: Based on our prospective gathered (December 2011 to April 2014) database, we analyzed the charts of patients who presented with anterior circulation acute ischemic stroke and elected for mechanical thrombectomy (MT). Patient age, NIHSS at admission, DWI-ASPECTS, pre-MT TICI score, CIS, post-MT TICI score, time from onset to reperfusion, 3-month mRS were analyzed. Patients were dichotomized into two groups: favorable (mRS≤2) and poor (mRS≥3) outcomes at 3-month follow-up. Univariate statistical analysis was carried out to determine which factors were the most determinant for patient outcome using the 3-month outcome. Then logistic regression analysis was performed to refine the results.
Results: A total of 287 consecutive patients were elected for anterior circulation MT, 160 patients had a CIS and 138 of them had a complete follow-up including a 3-month mRS. They were (72 males, 67 females; mean age: 64). Sixty-nine out of the 138 patients (50.0 %) had a favorable outcome at 3-month. The 3-month mortality was 18.1%. Good reperfusion (TICI ≥ 2b) was obtained in 77.1% of the patients. The mean time from stroke onset to reperfusion was 5.9 hours. Univariate analysis showed that the statistically significant factors for a favorable 3-month outcome were the CIS and the NIHSS at admission (p<0.0001), a successful reperfusion (p=0.0002) and a high DWI-ASPECTS (p=0.0006). Patient age, time from onset to reperfusion and pre-MT-TICI score did not influence the 3-month patient outcomes. Logistic regression showed ASPECTS (p=0.0133, odd ratio=0.698) and CIS (p=0.036, odd ratio=0.564) to be the most determinant factors of patient outcomes.
Conclusions: High initial CIS are associated with better outcomes in acute ischemic stroke patients who undergo MT arguing that, along with the infarct volume, the assessment of arterial collateral supply is a striking determinant of patient outcome.
Author Disclosures: P. Labeyrie: None. H. Redjem: Consultant/Advisory Board; Modest; Covidien, Stryker, Microvention, Balt, Penumbra. R. Blanc: Honoraria; Modest; Balt. Ownership Interest; Modest; Lazarus Effect. Consultant/Advisory Board; Modest; Covidien, Stryker, Microvention, Balt, Penumbra. B. Bartolini: Consultant/Advisory Board; Modest; Covidien, Stryker, Microvention, Balt, Penumbra. G. Ciccio: None. T. Robert: None. B. Gilboa: None. S. Pistocchi: Consultant/Advisory Board; Modest; Covidien, Stryker, Microvention, Balt, Penumbra. R. Fahed: None. M. Abrivard: None. M. Piotin: Honoraria; Modest; Covidien, Microvention. Ownership Interest; Modest; Lazarus Effect. Consultant/Advisory Board; Modest; Covidien, Stryker, Microvention, Balt, Penumbra.
- © 2015 by American Heart Association, Inc.