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. 2023 Jul 4:14:1205256.
doi: 10.3389/fneur.2023.1205256. eCollection 2023.

Functional outcome in low-ASPECTS (0-5) acute ischemic stroke treated with mechanical thrombectomy: impact of laterality explored in a single-center study

Victor Dumas #  1   2 , Killian Martin #  2 , Clément Giraud  1 , Julia Prigent  3 , William Bloch  3 , Karim Soualmi  2 , Guillaume Herpe  1   2 , Samy Boucebci  2 , Jean Philippe Neau  3 , Rémy Guillevin  1   2 , Stéphane Velasco  2
Affiliations

Functional outcome in low-ASPECTS (0-5) acute ischemic stroke treated with mechanical thrombectomy: impact of laterality explored in a single-center study

Victor Dumas et al. Front Neurol. .

Abstract

Background: There is no consensus regarding the influence of infarct laterality in patients with acute ischemic stroke due to anterior large vessel occlusion (AIS-LVO) treated with mechanical thrombectomy (MT), particularly in low-ASPECT (0-5) patients who were excluded from the initial MT studies and that participated in dedicated randomized-controlled trials that do not consider the side of the occlusion. We aimed to evaluate the role of infarct laterality on the clinical outcome in low-ASPECT AIS patients treated with MT.

Material and methods: We retrospectively analyzed our institutional stroke database in our Thrombectomy-Capable Stroke Center (TCSC), including patient characteristics, procedural variables, and outcomes, between January 2015 and January 2022. Patients with acute intracranial ICA and/or proximal MCA occlusions with ASPECT ≤ 5 either on CT or MRI were included and divided into 2 groups according to the location of ischemia. The primary endpoint was a good clinical outcome at 90 days (modified Rankin Scale (mRS) score of 0-3).

Results: Between January 2015 and November 2021, 817 MT were performed, of which 82 were low-ASPECT (10.0%): 41 left-sided and 41 right-sided strokes. The rates of good clinical outcome were 30.8% (12/41) for the left-sided group and 43.6% (17/41) for the right-sided group, with a p-value of 0.349. The morality rate showed no significant difference between the two groups: 39.0% (16/41) in the right stroke group and 36.6% (15/41) in the left stroke group.

Conclusion: The clinical outcome was not significantly influenced by stroke laterality. The results of this single-center retrospective study indicate either a lack of strength or equal value in performing mechanical thrombectomy regardless of stroke laterality.

Keywords: AIS-LVO; laterality; low-ASPECT; mechanical thrombectomy; stroke.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow chart.
Figure 2
Figure 2
Modified Rankin scale scores at 90 days according to stroke laterality, A modified Rankin sclare score of 0 indicates no disability, 1 no clinically significant disability, 2 slight disability, 3 moderate disability but able to walk unassisted, 4 moderately severe disability, 5 severe disability, and 6 death.
See this image and copyright information in PMC

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