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• W4319006547 abstract "Introduction: Heterogeneity of collateralization in patients with acute ischemic stroke (AIS) is a marker of fast versus slow progression of penumbral consumption and infarct expansion. Our aim was to evaluate the relationship between time-dependent stroke progression and incidence of intracranial hemorrhage (ICH) and acute neurological deficits. Methods: Retrospective chart review of patients presenting with anterior circulation large vessel occlusion (LVO)-associated AIS at our comprehensive stroke center with 24 hours last known normal (LKN) who underwent endovascular thrombectomy (EVT) without intra-arterial thrombolytics or non-thrombolytics were included. We used Alberta Stroke Program Early CT Score (ASPECTS) on initial non-contrast CT to identify slow versus fast progressors. ASPECTS <=7 was defined as fast progressor. Subgroup analysis was performed based on LKN <3 hours, 3-9 hours, and 9-24 hours. We evaluated rate of hemorrhagic transformation using ECASS-3 criteria and determined change in NIHSS from baseline to discharge. Mann-Whitney U test and Fisher exact test statistic with Social science statistics software used for data analysis. Results: From September 2019 to December 2021, out of 268 subjects who underwent EVT, 48 met inclusion criteria. Mean age was 65.29 (95% CI 61.32, 69.27), and median presenting NIHSS was 16 (95% CI 14.39, 18.40). Mean ASPECTS was 7.71 (95% CI 7.21, 8.20). There was significant difference is hemorrhagic transformation rate between ASPECTS >7 and <=7 (Fisher value=0.018). Sample size was not large enough to perform subgroup analysis based on last known normal. However, there was a trend towards increase in hemorrhagic transformation rate with greater time from last known well at same ASPECTS score. Slow progressors also had a significant improvement in presenting and discharge NIHSS as compared to fast progressors (z-score is -3.10, p-value is 0.002). Conclusion: Our study suggests that ASPECTS score as assessed in different time windows to differentiate fast versus slow progressors is not only a predictor of clinical outcome, but also independently associated with risk of hemorrhagic transformation. Larger, prospective studies are needed to validate our results." @default.
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• W4319006547 date "2023-02-01" @default.
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• W4319006547 title "Abstract WP128: Incidence Of Intracranial Hemorrhage And Clinical Outcomes In Fast Versus Slow Progressors As Defined By Aspects" @default.
• W4319006547 doi "https://doi.org/10.1161/str.54.suppl_1.wp128" @default.
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