More strict imaging based pacients selection could decrease mortality and severe neurological deficit after EVT treatment. The aim of our study was to analyze imaging-based criteria–computed tomography perfusion (CTP) core ASPECTS score and CT angiography collaterals pattern – before patient selection for reperfusion treatment (EVT) and evaluate three months functional outcome (modified Rankin scale -mRS) after treatment. We analyzed 208 patients in the mixed retrospective/prospective study (2015-2018) with large artery occlusion - 90 (43%) men and 118 (57%) women, and the median age was 72± 10.55 years. Two comparative initial CTP ASPECTS scoring groups were defined (≥ 7 and ≥ 6) and collaterals (good and poor) were used for patient evaluation in comparison with functional outcome (mRS). Majority of patients had MCA M1 segment occlusion 157 (75%) and 51 (25%) had ICA occlusion. Successful recanalization after EVT was 90% (TICI 2b-3) with mRS 0-2 after discharge and 3 months 62 (30%) vs 83 (40%), p<0.001, respectively. Small size CTP core (ASPECTS ≥ 7) with good collateral pattern showed higher potential risk OR 4.651 times, CI 95% (2.3 - 9.2) for good outcome (mRS 0-2) compared with CTP -core ASPECTS <7, p <0.001. After re-categorization of patients groups by ASPECTS ≥6 with good collaterals we revealed OR 4.738 times higher potential risk for 3 months good outcome (CI 95% (2.4-9.5),p<0.001) compared with CTP core ASPECTS <6, p<0.001. We found that CTP - core ASPECTS lower score at admission by each single point increases mortality rate 1.3 times (OR 1.346 times CI 95%[1.06-1.7]). Good clinical outcome in acute ischemic stroke shows significantly higher rate if initial imaging - based biomarkers are applied in patient selection for EVT: CTP core ASPECTS ≥6 with presence of good collaterals in contary with ASPECTS <6 has significant impact of each score point on mortality regardless collaterals.
- 3.4. Other publications in conference proceedings (including local)