RT Journal Article
SR Electronic
T1 O09 Early lesion water uptake modifies the treatment effect of mechanical thrombectomy in patients with low ASPECTS – A secondary analysis of the efficacy and safety of thrombectomy in stroke with extended lesion and extended time window (TENSION) trial
JF Journal of NeuroInterventional Surgery
JO J NeuroIntervent Surg
FD BMJ Publishing Group Ltd.
SP A6
OP A7
DO 10.1136/jnis-2024-ESMINT.9
VO 16
IS Suppl 2
A1 Broocks, Gabriel
A1 Meyer, Lukas
A1 Bendszus, Martin
A1 Simonsen, Claus
A1 Thomalla, Götz
A1 Gizewski, Elke
A1 Aamodt, Anne Hege
A1 Krajina, Antonin
A1 Pierot, Laurent
A1 Zeleňák, Kamil
A1 Fuentes, Blanca
A1 Hill, Michael
A1 Kniep, Helge
A1 Fiehler, Jens
YR 2024
UL http://jnis.bmj.com/content/16/Suppl_2/A6.abstract
AB Introduction The beneficial effect of endovascular treatment (EVT) on functional outcome in patients with ischemic stroke and low ASPECTS has recently been demonstrated. ASPECTS rating is based on the presence of ischemic lesion hypodensity, however the degree of hypoattenuation, directly indicating net water uptake (NWU), has not been considered for treatment selection..Aim of Study We hypothesized that the effect of EVT on functional outcome in low ASPECTS patients depends on early lesion NWU.Methods The TENSION trial was a randomized multicenter clinical trial including patients with anterior circulation stroke and ASPECTS 3-5. Net water uptake (NWU) was assessed as quantitative imaging biomarker on admission-CT. Primary endpoint was the rate of functional independence defined as modified Rankin Scale (mRS) 0-2 at day-90. The effect of EVT on functional outcome was analyzed according to the degree of NWU within the early infarct lesion.Results For this pilot study, 120 patients were included (51 EVT patients, 42%; 69 BMT patients). In patients with functional independence, the median NWU was 7.7% (IQR:4.7-9.0), which was lower compared to patients with mRS≥3 (median 12.1, IQR:9.3-16.6,p<0.001). In inverse-probability weighting analysis, the average treatment effect of EVT on functional independence was 27.4% (95%CI:13.5-41.3%) for patients with low NWU (<7.7%), while the effect of EVT in patients with high NWU (>7.7%) was 6.5% (95%CI:-0.1-14.3%)Conclusion The degree of relative lesion hypodensity on admission-CT (ie. NWU) modified the effect of EVT on functional outcome and should be considered as image criterion besides ASPECTS to select patients for EVT, particularly in borderline cases.Abstract O09 Figure 1 Abstract O09 Figure 2 Disclosure of Interest no.