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Related Concept Videos

Ischemic Stroke l: Introduction01:15

Ischemic Stroke l: Introduction

Ischemic stroke is an acute cerebrovascular condition in which blood flow to a brain region is suddenly interrupted, leading to tissue infarction. Neurons depend on continuous oxygen and glucose supply, so even brief reductions in perfusion cause energy failure, ionic imbalance, and irreversible injury. Ischemic strokes are classified into thrombotic and embolic types based on their underlying mechanisms.Thrombotic MechanismsThrombotic stroke develops when a clot forms within a cerebral artery.

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Visual Alberta stroke program early computed tomography score versus RAPID-AI perfusion in predicting outcome after

Quang Anh Nguyen1,2, Dang Luu Vu1,2, Thanh Tam Nguyen2

  • 1Department of Radiology, Hanoi Medical University, Hanoi, Vietnam.

Interventional Neuroradiology : Journal of Peritherapeutic Neuroradiology, Surgical Procedures and Related Neurosciences
|October 7, 2025
PubMed
Summary
This summary is machine-generated.

Visual Alberta Stroke Program Early CT Score (ASPECTS) on non-enhanced CT scans is a strong predictor of outcomes in patients undergoing mechanical thrombectomy for stroke beyond 6 hours. Automated perfusion imaging did not show similar prognostic value in this late-window treatment group.

Keywords:
ASPECTSAcute ischemic strokeRAPID-AIanterior large vessel occlusionmechanical thrombectomy

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Area of Science:

  • Neurology
  • Radiology
  • Medical Imaging

Background:

  • Mechanical thrombectomy (MT) is a key treatment for acute ischemic stroke.
  • Evaluating stroke severity and prognosis in the late window (6-24 hours) is crucial for treatment decisions.
  • Alberta Stroke Program Early CT Score (ASPECTS) and CT perfusion (CTP) are used to assess infarct core and penumbra.

Purpose of the Study:

  • To compare the prognostic utility of visual ASPECTS and automated RAPID-AI perfusion parameters for predicting functional independence after mechanical thrombectomy in the late window.
  • To determine if visual ASPECTS or CTP parameters are better predictors of 90-day functional outcomes.

Main Methods:

  • Retrospective analysis of 86 patients with anterior circulation large vessel occlusion undergoing MT between 6-24 hours.
  • Assessment of visual ASPECTS on NECT, and RAPID-ASPECTS and RAPID-CTP parameters (ischemic core, penumbra, mismatch ratio).
  • Multivariable logistic regression and ROC analysis to identify independent predictors of 90-day functional independence (mRS 0-2).

Main Results:

  • Visual ASPECTS (≥6) was significantly associated with favorable 90-day functional independence (AUC=0.709).
  • Automated RAPID-AI perfusion parameters did not reach statistical significance in predicting outcomes.
  • Visual ASPECTS, hypertension, and symptomatic intracranial hemorrhage were independent predictors of functional outcome.

Conclusions:

  • Visual ASPECTS assessed on non-enhanced CT is a superior predictor of clinical outcomes compared to automated perfusion parameters in patients undergoing late-window mechanical thrombectomy.
  • These findings highlight the continued importance of visual assessment of NECT in stroke management, especially when advanced imaging is limited.
  • Expert visual scoring remains relevant for predicting outcomes in extended time-window stroke interventions.