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Updated: Feb 26, 2026
Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Comparisons of ASPECTS 5 and 6 for endovascular treatment in anterior circulation occlusive stroke
Wenchen Li1, Shijun Li1, Meifen Dai1
11 Department of Neurology, Dongyang People's Hospital, Wenzhou Medical University, Dongyang, China.
Insights
Patients with ASPECTS 5 in anterior circulation stroke had significantly worse outcomes than ASPECTS 6. This study highlights the importance of ASPECTS scoring for predicting functional outcomes after endovascular treatment.
Area of Science:
- Neurology
- Interventional Neuroradiology
- Stroke Medicine
Background:
- The clinical significance of Alberta Stroke Program Early CT Score (ASPECTS) 5 versus ASPECTS 6 in acute anterior circulation ischemic stroke patients undergoing endovascular treatment is not well-established.
- Retrospective comparison of effectiveness and safety between ASPECTS 5 and ASPECTS 6 groups is crucial for treatment guidance.
Purpose of the Study:
- To compare the clinical outcomes, effectiveness, and safety of endovascular treatment in patients with acute anterior circulation large-artery occlusive stroke stratified by ASPECTS 5 and ASPECTS 6.
Main Methods:
- Retrospective analysis of 41 patients (14 in ASPECTS 5, 27 in ASPECTS 6) who underwent endovascular treatment.
- Functional outcome assessed by modified Rankin Scale (mRS 0-2) at 90 days.
- Symptomatic intracranial hemorrhage and mortality rates were recorded.
Main Results:
- Good functional outcome (mRS 0-2) at 90 days was significantly lower in the ASPECTS 5 group (0%) compared to the ASPECTS 6 group (25.9%, p=0.04).
- No significant differences were observed in symptomatic intracranial hemorrhage rates (21.4% vs 18.5%) or 90-day mortality (64.3% vs 44.4%).
- A trend towards lower successful reperfusion rates was noted in the ASPECTS 5 group (71.4% vs 92.6%).
Conclusions:
- ASPECTS 5 is associated with a very low probability of achieving good functional outcomes in Chinese patients with anterior circulation large-artery occlusive stroke.
- Further large-scale studies are warranted to validate these findings and refine treatment strategies.
Abstract:
Background Whether ASPECTS 5 and ASPECTS 6 were significantly different on clinical outcomes in acute anterior circulation ischemic stroke undergoing endovascular treatment remains unclear. We aimed to retrospectively compare the effectiveness and safety of ASPECTS 5 and ASPECTS 6 in acute anterior circulation large-artery occlusive stroke patients. Methods A total of 41 patients, 14 in the ASPECTS 5 group and 27 in the ASPECTS 6 group, were enrolled between January 2014 and June 2016. Modified Rankin Scale 0-2 was considered as good functional outcome. Symptomatic intracerebral hemorrhage at 72 hours and mortality at 90 days were recorded. Results Good functional outcome at 90 days in the ASPECTS 5 group (0% (0/14)) was significantly lower than that in the ASPECTS 6 group (25.9% (7/27)) ( p = 0.04). Rates of symptomatic intracranial hemorrhage (21.4 (3/14) vs 18.5% (5/27), p = 0.83) and mortality (64.3% (9/14) vs 44.4% (12/27), p = 0.23) within 90 days were not significantly different. There is a trend for a lower rate of successful reperfusion in the ASPECTS 5 group (71.4% (10/14) for ASPECTS 5 vs 92.6% (25/27) for ASPECTS 6, p = 0.07). Conclusions ASPECTS 5 has very little chance to reach good functional outcome in Chinese patients with anterior circulation large-artery occlusive stroke. Future studies with large sample sizes are needed.
