Stroke and vascular neurology · 2026
Association between ASPECTS regions and clinical outcomes following endovascular therapy in patients with large infarcts: a post hoc analysis of the ANGEL-ASPECT trial.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Zhao Jiahui, Zheng Lina, Nie Ximing, Wang Mengxing, Pu Shanyu, Liu Xin, Duan Wanying, Zhang Zhe, Liu Jingyi, Wei Yufei, Yang Zhonghua, Wen Miao, Leng Xinyi, Huo Xiaochuan, Pan Yuesong, Miao Zhongrong, Liu Liping
Аннотация
OBJECTIVE: To explore whether clinical outcomes following endovascular therapy (EVT) may differ according to infarct regions assessed by the Alberta Stroke Program Early CT Score (ASPECTS) in patients with large infarcts.
METHODS: This post hoc analysis of the ANGEL-ASPECT study included patients with acute ischaemic stroke due to anterior circulation large vessel occlusion and large infarcts. Patients were randomised to EVT or standard medical therapy (SMT) and stratified based on ASPECTS into two groups: subcortical regions involvement (caudate, lenticular nucleus or internal capsule) and cortical regions involvement (cortical areas). The primary outcome was the 90-day modified Rankin Scale (mRS) score. ANGEL-ASPECT is signed up to ClinicalTrials.gov, NCT04551664.
RESULTS: Of 455 patients, 395 (86.81%) with subcortical regions and 60 (13.19%) cortical regions infarcts. EVT was associated with a favourable shift in 90-day mRS scores in the subcortical regions group (OR 1.65; 95% CI 1.16 to 2.34; p<0.001), whereas no statistically significant difference was observed in the cortical regions group (OR 1.47; 95% CI 0.59 to 3.66; p=0.09). In the subcortical regions group, EVT was associated with better outcomes in left-side infarcts (OR 1.73; 95% CI 1.04 to 2.89; p=0.04). Similar trends were not statistically significant in right-side infarcts (OR 1.57; 95% CI 0.97 to 2.53; p=0.07).
CONCLUSIONS: In this exploratory post hoc analysis, EVT was associated with more favourable functional outcomes in patients with subcortical region involvement, particularly in left-sided infarcts. However, no significant interaction between infarct location and treatment assignment was observed, and these findings should be considered hypothesis-generating.
METHODS: This post hoc analysis of the ANGEL-ASPECT study included patients with acute ischaemic stroke due to anterior circulation large vessel occlusion and large infarcts. Patients were randomised to EVT or standard medical therapy (SMT) and stratified based on ASPECTS into two groups: subcortical regions involvement (caudate, lenticular nucleus or internal capsule) and cortical regions involvement (cortical areas). The primary outcome was the 90-day modified Rankin Scale (mRS) score. ANGEL-ASPECT is signed up to ClinicalTrials.gov, NCT04551664.
RESULTS: Of 455 patients, 395 (86.81%) with subcortical regions and 60 (13.19%) cortical regions infarcts. EVT was associated with a favourable shift in 90-day mRS scores in the subcortical regions group (OR 1.65; 95% CI 1.16 to 2.34; p<0.001), whereas no statistically significant difference was observed in the cortical regions group (OR 1.47; 95% CI 0.59 to 3.66; p=0.09). In the subcortical regions group, EVT was associated with better outcomes in left-side infarcts (OR 1.73; 95% CI 1.04 to 2.89; p=0.04). Similar trends were not statistically significant in right-side infarcts (OR 1.57; 95% CI 0.97 to 2.53; p=0.07).
CONCLUSIONS: In this exploratory post hoc analysis, EVT was associated with more favourable functional outcomes in patients with subcortical region involvement, particularly in left-sided infarcts. However, no significant interaction between infarct location and treatment assignment was observed, and these findings should be considered hypothesis-generating.