Post-endovascular Thrombectomy Contrast Extravasation and ASPECT Score in Acute Ischemic Stroke: Predictive Values for Outcome
Objective:
Investigate the predictive value of the post-EVT contrast extravasation and ASPECT score on the stroke outcome
Background:
Early endovascular therapy (EVT) is proven to be superior to the standard medical therapy for acute ischemic stroke (AIS).The mechanical thrombectomy requires contrast agents to enhance the visibility of the arteries, which can be seen as post EVT contrast extravasation. Follow up brain imaging after 24 hours would help in differentiating between contrast and blood component, as the contrast effect would not last for more than 24 hours and its presence was noticed to possibly be associated with poor functional outcome. ASPECT score post EVT is another possible prognostic factor based on the brain imaging that could correlate with the stroke outcome
Design/Methods:
Retrospective Study
Results:
A total of 46 patients post thrombectomy were evaluated, from which 18 were excluded for hemorrhagic transformation to solely investigate the post thrombectomy contrast extravasation phenomena. Out of the 28 patients who fulfilled the inclusion criteria, 14 had contrast extravasation while the remaining 14 did not have. The extravasation group's (EG) mean NIHSS score was 14, while the no-extravasation group's (NEG) mean score was 10. The baseline ASPECT, immediately after and 24-hour later were calculated and revealed to be as following respectively, first for EG: 9, 6 and 5 before excluding the hemorrhagic transformation and 9, 8, 7 after excluding them, while on other hand for the NEG they were 9, 9, and 8. The mRS at 90-days was worse at the EG where only 35 % had a score of 1-3, while more than 57 % of the NEG had a score of 1-3
Conclusions:
In Conclusion, the contrast extravasation post thrombectomy can help in predicting the functional status outcome of the AIS patients at the 90-day, and it may have a higher prognostic value compared to the ASPECT score