Outcomes Are Not Different between Patients with Intermediate and High DWI-ASPECTS after Stent-Retriever Embolectomy for Acute Anterior Circulation Stroke

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Fig 1.
Functional outcome (mRS 0–6) of 171 patients with acute anterior circulation stroke according to pretreatment DWI-ASPECTS. The proportion of outcomes (mRS 0–2 versus mRS 3–6) within each DWI-ASPECTS is shown.
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Fig 2.
Receiver operating characteristic curve of DWI-ASPECTS for prediction of a good outcome (mRS 0–2 at 3 months). AUC indicates area under the curve.
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Fig 3.
Impact of successful revascularization on functional outcome according to DWI-ASPECTS.

Table 1:

Baseline clinical characteristics of the study population

	Total (N = 171)	DWI-ASPECTS		P Value
	Total (N = 171)	7–10 (n = 120)	4–6 (n = 51)	P Value
Age (yr) (median) (IQR)	72 (63.5–78)	73 (65–78)	68 (60–74)	.014
Male sex	88 (51.5%)	58 (48.3%)	30 (58.8%)	.209
Risk factors
Hypertension	95 (55.6%)	69 (57.5%)	26 (51%)	.432
Diabetes mellitus	32 (18.7%)	22 (18.3%)	10 (19.6%)	.845
Coronary artery disease	20 (11.7%)	14 (11.7%)	6 (11.8%)	.985
Dyslipidemia	42 (24.6%)	35 (29.2%)	7 (13.7%)	.034^{^a}
Smoking	46 (26.9%)	27 (22.5%)	19 (37.3%)	.059^{^a}
Atrial fibrillation	87 (50.9%)	64 (53.3%)	23 (45.1%)	.324
Congestive heart failure	6 (3.5%)	5 (4.2%)	1 (1.9%)	.670^{^a}
History of stroke or TIA	22 (12.9%)	18 (15%)	4 (7.8%)	.317^{^a}
Intravenous thrombolysis	104 (60.8%)	71 (59.2%)	33 (64.7%)	.497
Time to treatment (min) (median) (IQR)	245 (190–310)	257.5 (190–315)	220 (190–281)	.155
Procedure time (min) (median) (IQR)	33 (20–50)	34 (20.5–50)	30 (20–43.5)	.444
Time to revascularization (min) (median) (IQR)	280 (223.5–352)	297.5 (228.5–355)	252 (221.5–326)	.136
Baseline NIHSS score (median) (IQR)	13 (10–16)	12 (9–15)	15 (12–18)	<.001
Stroke etiology
Large-artery atherosclerosis	43 (25.1%)	32 (26.7%)	11 (21.6%)	.482
Cardioembolism	99 (57.9%)	70 (58.3%)	29 (56.9%)	.859
Undetermined	28 (16.4%)	17 (14.2%)	11 (21.6%)	.231

↵a Comparisons were performed using the Fisher exact test. Comparisons of categoric variables were performed using χ² tests unless otherwise indicated.

Table 2:

Outcomes after stent-retriever embolectomy in 171 patients

↵a Comparisons were performed using the Fisher exact test. Comparisons of categoric variables were performed using χ² tests unless otherwise indicated.

Table 3:

Logistic regression analysis of predictors of good outcome

	Unadjusted OR	95% CI	P Value	Adjusted OR	95% CI	P Value
Age per 1-yr increase	0.947	0.918–0.976	<.001	0.941	0.909–0.974	.001
Baseline NIHSS, per 1-point increase	0.900	0.834–0.971	.006	–	–	–
Time to treatment	1	0.996–1.004	.999	–	–	–
Modified TICI 2b or 3	9.455	2.725–32.808	<.001	8.511	2.298–31.525	.001
Symptomatic hemorrhage	0.213	0.240–1.859	.125	–	–	–
DWI-ASPECTS, per 1-point increase	1.150	0.930–1.421	.196	–	–	–
DWI-ASPECTS ≥7 vs <7	1.603	0.823–3.120	.165	–	–	–