e-ASPECTS Correlates with and Is Predictive of Outcome after Mechanical Thrombectomy

Background and Purpose: The e-ASPECTS software is a tool for the automated use of ASPECTS. The aim was to analyze whether baseline e-ASPECTS scores correlate with outcome after mechanical thrombectomy.

Materials and Methods: Patients with anterior circulation ischemic stroke admitted 2010–2015, diagnosed by CT and treated with mechanical thrombectomy were included. Baseline ASPECTS was scored by e-ASPECTS and three expert raters (interclass correlation calculated), and e-ASPECTS was correlated with 3-month mRS. Unfavorable outcome was mRS 4–6; a poor scan was e-ASPECTS 0–5.

Results: 220 patients were included; median e-ASPECTS was 9. ICCs between e-ASPECTS and raters were 0.72, 0.74, and 0.76. e-ASPECTS correlated with 3-month mRS, and patients with unfavorable outcomes had lower e-ASPECTS. A poor scan (7.4% of patients) was associated with unfavorable outcome (OR 13.6). e-ASPECTS was an independent predictor of unfavorable outcome (OR 0.79).

Conclusions: e-ASPECTS correlated with 3-month mRS and was predictive of unfavorable outcome after mechanical thrombectomy, though further studies in patients with poor scans are needed.