Version 1
: Received: 14 June 2023 / Approved: 22 June 2023 / Online: 22 June 2023 (15:24:50 CEST)
How to cite:
Goswami, A.; Rau, N.A.; Dissin, J.; Hushen, P. Predicting Risk of Malignant Stroke in MCA stroke after Successful Re-canalization Using (A-P) Score. Preprints2023, 2023061640. https://doi.org/10.20944/preprints202306.1640.v1
Goswami, A.; Rau, N.A.; Dissin, J.; Hushen, P. Predicting Risk of Malignant Stroke in MCA stroke after Successful Re-canalization Using (A-P) Score. Preprints 2023, 2023061640. https://doi.org/10.20944/preprints202306.1640.v1
Goswami, A.; Rau, N.A.; Dissin, J.; Hushen, P. Predicting Risk of Malignant Stroke in MCA stroke after Successful Re-canalization Using (A-P) Score. Preprints2023, 2023061640. https://doi.org/10.20944/preprints202306.1640.v1
APA Style
Goswami, A., Rau, N.A., Dissin, J., & Hushen, P. (2023). Predicting Risk of Malignant Stroke in MCA stroke after Successful Re-canalization Using (A-P) Score. Preprints. https://doi.org/10.20944/preprints202306.1640.v1
Chicago/Turabian Style
Goswami, A., Jonathan Dissin and Patricia Hushen. 2023 "Predicting Risk of Malignant Stroke in MCA stroke after Successful Re-canalization Using (A-P) Score" Preprints. https://doi.org/10.20944/preprints202306.1640.v1
Abstract
A retrospective cohort study was performed to determine the likelihood of malignant stroke after mechanical thrombectomy via ASPECTS-PASS score(A-P score), a novel scoring system using ASPECT score and number of arterial-passes. This prediction score is designed to help clinicians take early measures. Malignant stroke is defined as a large MCA infarct with mass effect that develops during the first 5 days following presentation and is associated with approximately 80% mortality. Previous studies have shown an association of low ASPECTS and high number of passes with poor outcome.We performed a retrospective cohort analysis on 78 patients with anterior circulation stroke who underwent mechanical thrombectomy at our hospital. We analyzed the likelihood of developing malignant stroke post thrombectomy in the first 5 days following successful recanalization (TICI ≽ 2b). Malignant stroke is defined as severe symptoms secondary to edema as evidenced by midline shift, cistern engorgement, and hemorrhagic conversion with edema. Patients with ASPECTS of 0-5 were excluded. We used two variables to predict the outcome: ASPECT score and number-of-passes. We used the equation ASPECT score minus number-of-passes (A-P) to arrive at a single number to predict the risk of malignant stroke. A-P scoring scale ranged from 0-9. Our study showed a statistically significant inverse relationship of A-P score and risk of malignant stroke. Approximately 90% of patients with A-P score < 5 developed malignant stroke in our study. A-P score can help predict malignant stroke post thrombectomy even after successful recanalization. Thus, A-P score of ≤ 5 suggests very high risk. (A-P) Score can assist clinicians to take early measures, and thereby prevent worse outcomes.
Keywords
ASPECTS: Alberta Stroke Program Early CT Score; NIHSS: National Institutes of Health Stroke Scale; TICI: Thrombolysis in cerebral infarction; MCA: Middle Cerebral Artery; CBF: Cerebral Blood Flow; ICP: Intracerebral Pressure; CPP: Cerebral Perfusion Pressure; ADAPT: A Direct Aspiration First Pass Technique
Subject
Medicine and Pharmacology, Neuroscience and Neurology
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
