Correlation between Clinical Outcomes and Baseline CT and CT Angiographic Findings in the SWIFT PRIME Trial

Area of Science:

• Neurology
• Interventional Radiology

Background:

• Patient selection for endovascular therapy in acute ischemic stroke is challenging.
• Baseline imaging characteristics influence treatment outcomes.

Purpose of the Study:

• To evaluate the impact of baseline CT and angiography on outcomes in the SWIFT PRIME trial.
• To identify patient subgroups who benefit most from endovascular stroke therapy.

Main Methods:

• Analysis of baseline ASPECTS, occlusion site, clot length, and collateral status.
• Subgroup analysis and classification and regression tree (CART) analysis were performed.

Main Results:

• Thrombectomy showed improved outcomes compared to IV tPA alone, particularly in patients with smaller baseline infarcts (ASPECTS 8-10).
• Benefit of thrombectomy was observed across various occlusion locations and collateral statuses.
• Optimal outcomes were achieved in patients with favorable ASPECTS, complete recanalization, and early treatment.

Conclusions:

• Endovascular therapy provides benefits across multiple subgroups of acute ischemic stroke patients.
• The greatest treatment response is seen in patients with small baseline infarcts, excellent collaterals, and early intervention.