The association between diffusion-weighted imaging-Alberta Stroke Program Early Computed Tomography Score and the outcome following mechanical thrombectomy of anterior circulation occlusion

Hashimoto, Hiroaki; Maruo, Tomoyuki; Kimoto, Yuki; Nakamura, Masami; Fujinaga, Takahiro; Nakamura, Hajime; Ushio, Yukitaka

doi:https://doi.org/10.1016/j.inat.2023.101758

The association between diffusion-weighted imaging-Alberta Stroke Program Early Computed Tomography Score and the outcome following mechanical thrombectomy of anterior circulation occlusion

Hashimoto, Hiroaki; Maruo, Tomoyuki; Kimoto, Yuki et al.

Interdisciplinary Neurosurgery: Advanced Techniques and Case Management, 2023, 33, 101758

Number of Access:659（2025-08-26 04:19 Counts）

Identifier to cite or link to this item: https://hdl.handle.net/11094/95631

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Title	The association between diffusion-weighted imaging-Alberta Stroke Program Early Computed Tomography Score and the outcome following mechanical thrombectomy of anterior circulation occlusion
Creator	NRID 1000050770674 1000050770674 ORCID 0000-0003-4057-4466 0000-0003-4057-4466 researchmap permalink yousyou0720 yousyou0720 Scopus Author ID 56922570200 56922570200 CreatorName Hashimoto, Hiroaki
	NRID 1000090533810 1000090533810 researchmap permalink tomaruo0611 tomaruo0611 CreatorName Maruo, Tomoyuki
	NRID 1000010889645 1000010889645 CreatorName Kimoto, Yuki
	CreatorName Nakamura, Masami
	CreatorName Fujinaga, Takahiro
	NRID 1000080533794 1000080533794 researchmap permalink hnns-osaka hnns-osaka Scopus Author ID 55624478238 55624478238 CreatorName Nakamura, Hajime
	NRID 1000020028583 1000020028583 CreatorName Ushio, Yukitaka
Subject	DWI-ASPECTS
	Large-vessel occlusion
	Mechanical thrombectomy
	Stroke
Description	Hashimoto H., Maruo T., Kimoto Y., et al. The association between diffusion-weighted imaging-Alberta Stroke Program Early Computed Tomography Score and the outcome following mechanical thrombectomy of anterior circulation occlusion. Interdisciplinary Neurosurgery: Advanced Techniques and Case Management 33, 101758 (2023); https://doi.org/10.1016/j.inat.2023.101758.
Abstract	Background: Although preoperative diffusion-weighted imaging-Alberta Stroke Program Early Computed Tomography Score (DWI-ASPECTS) is well known as a predictor of outcomes after mechanical thrombectomy (MT) for large-vessel occlusion (LVO), assessment of changes in DWI-ASPECT from before to after MT is rare. Therefore, we clarified the relationship between the change in DWI-ASPECTS and clinical outcomes. Methods: In this retrospective single-center study, we enrolled 63 cases of anterior LVOs treated with MT between April 2015 and March 2022. Preoperative and postoperative DWI-ASPECTSs were calculated. DWI-ASPECTSs were categorized into cortical-ASPECTSs (c-ASPECTSs) and subcortical ASPECTSs and assessed. Additionally, medical variables related to patients, such as sex, age, National Institutes of Health Stroke Scale (NIHSS) score, and premorbid modified Rankin Scale (mRS) score, were evaluated. A good outcome was defined as an mRS score of 0–2 at 3 months. Results: Forty-five patients met the inclusion criteria. Nine (20 %) had a good outcome. The good outcome group showed significantly higher postoperative DWI-ASPECTs (median 8 vs. 5, p = 0.012) and c-ASPECTSs (median 4 vs. 3, p = 0.020) than the poor outcome group. No difference in DWI-ASPECTSs and c-ASPECTSs from before to after MT were significantly associated with the good outcome (p = 0.017, p = 0.016, respectively). The cut-off values for the good outcome on receiver operating characteristic curve analysis for differences between DWI-ASPECTSs and c-ASPECTSs were 0 [area under the curve (AUC) 0.77] and 0 [AUC 0.74]. Logistic regression analyses showed that baseline NIHSS score (odds ratio, 0.69; 95 % confidence interval 0.48–1.00; p = 0.046) and postoperative DWI-ASPECTS (odds ratio, 2.27; 95 % confidence interval 1.02–5.04; p = 0.039) were independent factors for the good outcome. Conclusions: The good outcome of patients with anterior LVO was associated with no difference in DWI-ASPECTSs and c-ASPECTSs from before to after MT.
Publisher	Elsevier B.V.
Source Title	Interdisciplinary Neurosurgery: Advanced Techniques and Case Management
Volume (Issue)	33
Page	101758
Date of Issued	2023-09-01
Language	English
Handle URL	https://hdl.handle.net/11094/95631
eISSN	22147519
Relation.isIdenticalTo	DOI (Publisher Version) https://doi.org/10.1016/j.inat.2023.101758
Access Rights	open access
CopyRight	This article is licensed under a Creative Commons Attribution 4.0 International License.
oaire:version	Version of Record
Category	学術雑誌論文 Journal Article

Resource Type	journal article
Local Type	Journal Article
DCMI Type	Text
DCTERMS.bibliographicCitation	Interdisciplinary Neurosurgery: Advanced Techniques and Case Management. 2023, 33, p. 101758
DC.title	The association between diffusion-weighted imaging-Alberta Stroke Program Early Computed Tomography Score and the outcome following mechanical thrombectomy of anterior circulation occlusion
DC.creator	Hashimoto, Hiroaki
	Maruo, Tomoyuki
	Kimoto, Yuki
	Nakamura, Masami
	Fujinaga, Takahiro
	Nakamura, Hajime
	Ushio, Yukitaka
DC.publisher	Elsevier B.V.
DC.language' scheme='DCTERMS.RFC1766	English
DC.type' scheme='DCTERMS.DCMIType	Text
DCTERMS.issued' scheme='DCTERMS.W3CDTF	2023-09-01
DC.identifier	https://doi.org/10.1016/j.inat.2023.101758
DC.subject	DWI-ASPECTS
	Large-vessel occlusion
	Mechanical thrombectomy
	Stroke
DC.description	Hashimoto H., Maruo T., Kimoto Y., et al. The association between diffusion-weighted imaging-Alberta Stroke Program Early Computed Tomography Score and the outcome following mechanical thrombectomy of anterior circulation occlusion. Interdisciplinary Neurosurgery: Advanced Techniques and Case Management 33, 101758 (2023); https://doi.org/10.1016/j.inat.2023.101758.
DCTERMS.abstract	Background: Although preoperative diffusion-weighted imaging-Alberta Stroke Program Early Computed Tomography Score (DWI-ASPECTS) is well known as a predictor of outcomes after mechanical thrombectomy (MT) for large-vessel occlusion (LVO), assessment of changes in DWI-ASPECT from before to after MT is rare. Therefore, we clarified the relationship between the change in DWI-ASPECTS and clinical outcomes. Methods: In this retrospective single-center study, we enrolled 63 cases of anterior LVOs treated with MT between April 2015 and March 2022. Preoperative and postoperative DWI-ASPECTSs were calculated. DWI-ASPECTSs were categorized into cortical-ASPECTSs (c-ASPECTSs) and subcortical ASPECTSs and assessed. Additionally, medical variables related to patients, such as sex, age, National Institutes of Health Stroke Scale (NIHSS) score, and premorbid modified Rankin Scale (mRS) score, were evaluated. A good outcome was defined as an mRS score of 0–2 at 3 months. Results: Forty-five patients met the inclusion criteria. Nine (20 %) had a good outcome. The good outcome group showed significantly higher postoperative DWI-ASPECTs (median 8 vs. 5, p = 0.012) and c-ASPECTSs (median 4 vs. 3, p = 0.020) than the poor outcome group. No difference in DWI-ASPECTSs and c-ASPECTSs from before to after MT were significantly associated with the good outcome (p = 0.017, p = 0.016, respectively). The cut-off values for the good outcome on receiver operating characteristic curve analysis for differences between DWI-ASPECTSs and c-ASPECTSs were 0 [area under the curve (AUC) 0.77] and 0 [AUC 0.74]. Logistic regression analyses showed that baseline NIHSS score (odds ratio, 0.69; 95 % confidence interval 0.48–1.00; p = 0.046) and postoperative DWI-ASPECTS (odds ratio, 2.27; 95 % confidence interval 1.02–5.04; p = 0.039) were independent factors for the good outcome. Conclusions: The good outcome of patients with anterior LVO was associated with no difference in DWI-ASPECTSs and c-ASPECTSs from before to after MT.
DC.rights	This article is licensed under a Creative Commons Attribution 4.0 International License.
DC.format	95631
citation_title	The association between diffusion-weighted imaging-Alberta Stroke Program Early Computed Tomography Score and the outcome following mechanical thrombectomy of anterior circulation occlusion
citation_author	Hashimoto, Hiroaki
	Maruo, Tomoyuki
	Kimoto, Yuki
	Nakamura, Masami
	Fujinaga, Takahiro
	Nakamura, Hajime
	Ushio, Yukitaka
citation_publisher	Elsevier B.V.
citation_language	English
citation_date	2023-09-01
citation_journal_title	Interdisciplinary Neurosurgery: Advanced Techniques and Case Management
citation_volume	33
citation_firstpage	101758
citation_doi	https://doi.org/10.1016/j.inat.2023.101758
citation_public_url	https://hdl.handle.net/11094/95631

The association between diffusion-weighted imaging-Alberta Stroke Program Early Computed Tomography Score and the outcome following mechanical thrombectomy of anterior circulation occlusion

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