volumetry

INTRODUCTION: To determine whether imaging biomarkers or clinical characteristics could be used to predict recanalisation and 90-day outcomes in stroke patients undergoing mechanical thrombectomy. METHODS: Forty-three patients undergoing mechanical thrombectomy between 2009 and 2015 were included for analysis. Non-contrast CT (NCCT) determined clot density in Hounsfield Units (HU) and volume, along with Alberta Stroke Program Early CT Score (ASPECTS) on admission and at 24 h. CT angiography (CTA) yielded clot length, clot burden score (CBS) and collateral score (CS). Intraoperative fluoroscopy was used to determine thrombolysis in cerebral infarction (TICI) scores pre- and post-treatment. The principle outcome measure was the modified Rankin Scale (mRS) at 90 days. RESULTS: The only biomarker in the acute phase that predicted 90-day mRS was admission ASPECTS (p=0.0186). Non-significant trends towards positive outcome were seen with low clot volume (p=0.45), shorter clot length (p=0.33) and favourable collateral score (2 or 3, p=0.319). There was no association between outcome and clot density (p=0.67) or CBS (p=0.792). None of the biomarkers significantly predicted successful recanalisation. CONCLUSIONS: ASPECTS can be used to predict 90-day-mRS and thus outcomes in hyperacute stroke patients.