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• W2912170692 abstract "Background and Purpose: Optimal patient selection for thrombectomy in large vessel acute ischemic stroke (LVOS) remain to be established. We evaluated the performance of imaging paradigms in a cohort of endovascularly-treated LVOS. Methods: Review of a prospectively collected database of endovascular patients with anterior circulation LVOS, adequate CTP maps, and NIHSS ≥10 from January 2014-June 2018 in a clinical setting where no specific ASPECTS or CTP criteria defined treatment selection. Patients were assessed for thrombectomy eligibility by each 2 mismatch criteria: DAWN Clinical-Core Mismatch (DAWN-CCM): between age-adjusted NIHSS and CTP-derived ischemic core volume and modified Clinical-ASPECTS Mismatch (mCAM) defined as ASPECTS 6-10 and one of the following criteria: NIHSS ≥ 10 and 0-1 Cortical-ASPECTS (M1-6 area) Involvement (any age);NIHSS ≥ 10 and 0-2 Cortical-ASPECTS (M1-6 areas) Involvement (and age < 80 years old);NIHSS ≥ 20 and 0-3 Cortical-ASPECTS (M1-6 areas) Involvement (and age < 80 years old). Clinical outcomes were compared. Results: 591 patients qualified. mCAM had a higher inclusion rate as compared to the DAWN-CCM criteria (89.8%vs83.9%). The proportions of selected patients were statistically different between groups (p=0.01). Both mCAM(+) and DAWN-CCM(+) patients had higher rates of 90-day good outcomes (modified Rankin scale 0-2) compared to non-selected counterparts (53.2%vs21.3%,p<0.0001 and 52.5%vs35.5%,p=0.09 respectively). mCAM(+) had lower rates of 90-day mortality than mCAM(-) patients (17.5% vs 29.8%,p=0.04). However there was no difference in mortality between DAWN-CCM (+) and DAWN-CCM(-) patients (17.7% vs 25%,p=0.15). The abilities of mCAM and CCM to predict good outcomes were similar as assessed by the c-statistic, Akaike and Bayesian information criterion. Sensitivity analyses for the early (within 6H after symptom onset) and late (6-24H) time windows yielded similar results. Conclusion: mCAM and DAWN-CCM selection paradigms have similar inclusion rates and outcome discrimination ability. mCAM could represent a good substitute in centers where access to advanced imaging is more limited. Future studies are warranted." @default.
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• W2912170692 date "2019-02-01" @default.
• W2912170692 modified "2023-09-26" @default.
• W2912170692 title "Abstract 1: DAWN versus Modified Clinical-ASPECTS Mismatch Selection for Stroke Endovascular Therapyin the Early and Late Time Windows" @default.
• W2912170692 doi "https://doi.org/10.1161/str.50.suppl_1.1" @default.
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