Value of Aspects in recover prognosis in patients with acute anterior circulation ischemic stroke undergoing mechanical thrombectomy

Abstract

Purpose: Comparison of the prognostic value of recovery of the ASPECTS score compared with perfusion imaging in patients with acute anterior circulation cerebral infarction undergoing thrombectomy.
Methods: Retrospective cross-sectional descriptive study combined with prospective study of 60 cases undergoing CT scan without injection, CTA, CTP, using RAPID software to calculate core and penumbra values and mechanical thrombectomy within 6-24 hours. from the time of onset at Dien Quang center, Bach Mai hospital from January 2023 to January 2024. Good and poor stroke outcomes were assessed at 3 months by the modified Rankin functional recovery score (mRS). Use the ROC curve and AUC value to compare the good and bad stroke prognostic value of ASPECTS and the core, penumbra, mismatch ratio values.
Results: From January 2023 to January 2024, 60 patients were included in the study. At 90 days, the independent outcome rate of good mRS
function was 58%, poor mRS function was 42%. The ROC curve showed that, among the ASPECTS, core, penumbra and mismatch ratio indices, only
ASPECTS had the ability to predict stroke outcome well (p <0.05).
Conclusion: ASPECTS ≥ 6 has the ability to predict good functional recovery after stroke in patients with acute anterior circulation cerebral
infarction undergoing thrombectomy at the extended window. From there, it is possible to consider using ASPECTS ≥ 6 to replace CTP in disease
selection for mechanical thrombectomy at medical facilities that do not
have advanced imaging diagnostic facilities.