{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T06:17:44Z","timestamp":1788329864406,"version":"build-2803163510"},"reference-count":33,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"17","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,9,1]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">This study aimed to develop and validate a practical and reliable tool for comprehensive assessment of brain lesions on immediate post\u2010endovascular therapy (EVT) noncontrast computed tomography\u00a0(CT) and to predict 90\u2010day functional outcomes in patients with acute ischemic stroke.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">We retrospectively reviewed consecutive\u00a0patients with acute ischemic stroke undergoing EVT from 2 academic hospitals as the development cohort and used an independent national multicenter prospective cohort for external validation. The new score was derived from the Alberta Stroke Program Early CT\u00a0Score (ASPECTS) on the immediate post\u2010EVT non\u2010contrast CT, integrating both hyperdensity and hypodensity signs, named comprehensive Alberta Stroke Program Early CT Score (Co\u2010ASPECTS). Unfavorable outcome was defined as modified Rankin Scale score of 3 to 6 at 90\u2009days.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">A total of 1015 patients were included (development cohort: 542; validation cohort: 473). Co\u2010ASPECTS, formulated through equal\u2010weight summation of hyperdensity and hypodensity signs and consistent with the 0 to 10 score ASPECTS framework, was significantly associated with unfavorable outcomes (adjusted odds ratio, 0.45 [95% CI, 0.40\u20130.51]). It showed discrimination for functional outcome with a C\u2010statistic of 0.889 in the development cohort, outperforming conventional models including baseline ASPECTS and immediate post\u2010EVT ASPECTS that calculated based on hyperdensity or hypodensity signs alone. In the validation cohort, Co\u2010ASPECTS maintained robust performance (C\u2010statistic, 0.847). It also appeared to reflect both infarct burden and secondary injury, showing associations with final infarction and intracranial hemorrhage.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Co\u2010ASPECTS may serve as a promising tool with reliability and practicality for assessing brain lesions and predicting functional outcomes of patients with acute ischemic stroke who underwent EVT in clinical practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.126.051171","type":"journal-article","created":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T11:44:47Z","timestamp":1787226287000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Assessing Brain Lesions and Predicting Functional Outcome in Patients With Anterior Circulation Stroke With Endovascular Therapy: Co\u2010ASPECTS"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-4195-5018","authenticated-orcid":false,"given":"Jiaqi","family":"Luo","sequence":"first","affiliation":[{"name":"Ganzhou Hospital\u2010Nanfang Hospital, Southern Medical University","place":["Ganzhou, China"]},{"name":"Nanfang Hospital, Southern Medical University","place":["Guangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9959-2170","authenticated-orcid":false,"given":"Xiaolin","family":"Zhao","sequence":"additional","affiliation":[{"name":"Nanfang Hospital, Southern Medical University","place":["Guangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengxuan","family":"Xiao","sequence":"additional","affiliation":[{"name":"Nanfang Hospital, Southern Medical University","place":["Guangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guoshuai","family":"Yang","sequence":"additional","affiliation":[{"name":"Central South University Xiangya School of Medicine Affiliated Haikou Hospital","place":["Haikou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pengxiang","family":"Li","sequence":"additional","affiliation":[{"name":"The Second Affiliated Hospital of Hainan Medical University","place":["Haikou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weihua","family":"Liu","sequence":"additional","affiliation":[{"name":"Guangdong Provincial Hospital of Chinese Medicine, Hainan Hospital","place":["Haikou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2744-1984","authenticated-orcid":false,"given":"Suyue","family":"Pan","sequence":"additional","affiliation":[{"name":"Nanfang Hospital, Southern Medical University","place":["Guangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yidong","family":"Deng","sequence":"additional","affiliation":[{"name":"Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University","place":["Haikou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8136-3713","authenticated-orcid":false,"given":"Xianghong","family":"Liu","sequence":"additional","affiliation":[{"name":"Ganzhou Hospital\u2010Nanfang Hospital, Southern Medical University","place":["Ganzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3360-7031","authenticated-orcid":false,"given":"Kaibin","family":"Huang","sequence":"additional","affiliation":[{"name":"Ganzhou Hospital\u2010Nanfang Hospital, Southern Medical University","place":["Ganzhou, China"]},{"name":"Nanfang Hospital, Southern Medical University","place":["Guangzhou, 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