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Updated: Dec 6, 2025

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
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Post-stroke ASPECTS predicts outcome after thrombectomy.

Ronen R Leker1, Asaf Honig2, Andrei Filioglo2

  • 1Department of Neurology, Hadassah-Hebrew University Medical Center, P.O. Box 12000, 91120, Jerusalem, Israel. leker@hadassah.org.il.

Neuroradiology
|October 7, 2020
PubMed
Summary
This summary is machine-generated.

A post-treatment ASPECTS score of 7 or higher after endovascular thrombectomy for large vessel occlusion stroke indicates a better prognosis. This simple imaging metric predicts favorable outcomes and survival in stroke patients.

Keywords:
ASPECTSCerebrovascular diseaseEndovascularStrokeThrombectomy

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Area of Science:

  • Neurology
  • Radiology
  • Interventional Cardiology

Background:

  • Final infarct volume is a key determinant of outcomes after endovascular thrombectomy (EVT) for large vessel occlusion (LVO) stroke.
  • Current methods for measuring final infarct volume are complex and time-consuming.
  • A simpler prognostic tool is needed to evaluate patients post-EVT.

Purpose of the Study:

  • To evaluate the utility of the post-EVT Alberta Stroke Program Early CT Score (ASPECTS) as a prognostic tool.
  • To determine if ASPECTS-POST can predict outcomes following EVT for LVO stroke.

Main Methods:

  • A prospective cohort of 272 LVO stroke patients undergoing EVT was analyzed.
  • Baseline infarct size was assessed using admission non-contrast CT ASPECTS.
  • Post-EVT ASPECTS (ASPECTS-POST) was calculated from CT scans obtained 24-72 hours post-procedure.
  • Outcomes, including 90-day survival and modified Rankin Scale scores, were assessed.

Main Results:

  • 166 patients (61%) had an ASPECTS-POST score of 7 or higher.
  • ASPECTS-POST ≥ 7 was significantly associated with favorable outcomes (67% vs. 21%, p < 0.001).
  • Multivariate analysis confirmed ASPECTS-POST ≥ 7 as a significant predictor of favorable outcome (OR 6.2) and survival (OR 5.8).

Conclusions:

  • The ASPECTS-POST score can be rapidly and easily determined from post-EVT non-contrast CT.
  • An ASPECTS-POST score of 7 or higher strongly correlates with good clinical outcomes and improved survival after EVT for LVO stroke.