BACKGROUND: Favorable imaging profile according to the Alberta Stroke Program Early CT Score (ASPECTS) on non-contrast head CT is a key criterion for the selection of patients with ischemic stroke from large vessel occlusion (LVO) for IA revascularization therapies. OBJECTIVE: To analyze factors associated with changes in ASPECTS during inter-hospital transfer and to determine how deterioration of ASPECTS affects eligibility for endovascular procedures. METHODS: We analyzed factors associated with changes in ASPECTS during inter-hospital transfer and their potential impact on eligibility for IA stroke therapies in patients with anterior circulation ischemic strokes. Clinical and demographic characteristics between patients with favorable (ASPECTS ≥6) and unfavorable (ASPECTS <6) imaging on repeat CT were compared. RESULTS: Stroke evolution towards unfavorable ASPECTS occurred in 13/42 (31%) patients who initially had a favorable imaging profile at outside hospitals. A higher National Institutes of Health Stroke Scale (NIHSS) score was the only significant predictor of ASPECTS decay, whereas other clinical characteristics, such as the use of IV thrombolysis and site of LVO, were similar between the two groups. CONCLUSIONS: In our cohort, one out of three patients became ineligible for IA thrombectomy because of unfavorable ASPECTS 'decay' following inter-hospital transfer. Except for NIHSS severity, baseline clinical factors could not identify which patients were at risk for ASPECTS deterioration. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
BACKGROUND: Favorable imaging profile according to the Alberta Stroke Program Early CT Score (ASPECTS) on non-contrast head CT is a key criterion for the selection of patients with ischemic stroke from large vessel occlusion (LVO) for IA revascularization therapies. OBJECTIVE: To analyze factors associated with changes in ASPECTS during inter-hospital transfer and to determine how deterioration of ASPECTS affects eligibility for endovascular procedures. METHODS: We analyzed factors associated with changes in ASPECTS during inter-hospital transfer and their potential impact on eligibility for IA stroke therapies in patients with anterior circulation ischemic strokes. Clinical and demographic characteristics between patients with favorable (ASPECTS ≥6) and unfavorable (ASPECTS <6) imaging on repeat CT were compared. RESULTS:Stroke evolution towards unfavorable ASPECTS occurred in 13/42 (31%) patients who initially had a favorable imaging profile at outside hospitals. A higher National Institutes of Health Stroke Scale (NIHSS) score was the only significant predictor of ASPECTS decay, whereas other clinical characteristics, such as the use of IV thrombolysis and site of LVO, were similar between the two groups. CONCLUSIONS: In our cohort, one out of three patients became ineligible for IA thrombectomy because of unfavorable ASPECTS 'decay' following inter-hospital transfer. Except for NIHSS severity, baseline clinical factors could not identify which patients were at risk for ASPECTS deterioration. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
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Authors: Victor Lopez-Rivera; Sergio Salazar-Marioni; Rania Abdelkhaleq; Sean I Savitz; Alexandra L Czap; Yazan J Alderazi; Peng R Chen; James C Grotta; Spiros L Blackburn; Wesley Jones; Gary Spiegel; Mark J Dannenbaum; Tzu-Ching Wu; Joseph Cochran; Dong H Kim; Arthur L Day; Grace Farquhar; Louise D McCullough; Sunil A Sheth Journal: Stroke Date: 2021-02-04 Impact factor: 7.914
Authors: Aldo A Mendez; Edgar A Samaniego; Sunil A Sheth; Sudeepta Dandapat; David M Hasan; Kaustubh S Limaye; Bradley J Hindman; Colin P Derdeyn; Santiago Ortega-Gutierrez Journal: Crit Care Res Pract Date: 2018-06-28
Authors: Kori S Zachrison; Thabele M Leslie-Mazwi; Gregoire Boulouis; Joshua N Goldstein; Robert W Regenhardt; Anand Viswanathan; Arne Lauer; Khawdja Ahmer Siddiqui; Andreas Charidimou; Natalia Rost; Lee H Schwamm Journal: Neurol Clin Pract Date: 2019-10