{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T15:17:12Z","timestamp":1773933432554,"version":"3.50.1"},"reference-count":45,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["SVIN"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Current American guidelines are uncertain regarding endovascular treatment (EVT) for patients with acute ischemic stroke with an Alberta Stroke Program Early Computed Tomography Score (ASPECTS) &lt;6. Dutch guidelines do not specify ASPECTS\u2010based exclusion criteria for EVT. In this retrospective observational cohort study, we investigated outcomes of EVT in patients with low ASPECTS in the MR CLEAN (Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in The Netherlands) registry.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">ASPECTS was trichotomized into 0 to 2, 3 to 5, and 6 to 10, according to the grouping used in the ongoing trials. The effect of ASPECTS (granular and trichotomized) on 90\u2010day functional outcome (modified Rankin Scale score) and symptomatic intracranial hemorrhage was assessed with multivariable logistic regression. We included multiplicative interaction terms to evaluate treatment interaction between ASPECTS and reperfusion (extended thrombolysis in cerebral infarction score 2B\u20103) as a proxy for EVT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Among 3075 included patients, higher ASPECTS was associated with improved functional outcome (granular: adjusted common odds ratio [acOR], 1.06; 95% CI, 1.02\u20131.10; trichotomized: acOR, 1.52; 95% CI, 1.23\u20131.87). Interaction with reperfusion was not significant (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.99 for granular,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.76 for trichotomized ASPECTS). All ASPECTS subgroups showed benefit of reperfusion (0\u20132 [n\u00a0=\u00a039]: acOR, 7.40; 95% CI, 1.41\u201318.68; 3\u20135 [n\u00a0=\u00a0214]: acOR, 1.95; 95% CI, 1.13\u20133.34; 6\u201310 [n\u00a0=\u00a02822]: acOR, 2.41; 95% CI, 2.08\u20132.80). ASPECTS was not associated with symptomatic intracranial hemorrhage (granular: acOR, 1.00; 95% CI, 0.92\u20131.10, trichotomized: acOR, 0.92; 95% CI, 0.60\u20131.41).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p xml:lang=\"en\">Benefit of reperfusion was not modified by baseline ASPECTS. Patients in all ASPECTS subgroups showed benefit of reperfusion. These findings do not support withholding EVT on the basis of low ASPECTS only.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/svin.121.000199","type":"journal-article","created":{"date-parts":[[2022,4,26]],"date-time":"2022-04-26T06:50:25Z","timestamp":1650955825000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Endovascular Treatment May Benefit Patients With Low Baseline Alberta Stroke Program Early CT Score: Results From the MR CLEAN Registry"],"prefix":"10.1161","volume":"2","author":[{"given":"Manon","family":"Kappelhof","sequence":"first","affiliation":[{"name":"Amsterdam UMC, University of Amsterdam","place":["Amsterdam, The Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ivo G.H.","family":"Jansen","sequence":"additional","affiliation":[{"name":"Nico.Lab B.V.","place":["Amsterdam, The Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johanna M.","family":"Ospel","sequence":"additional","affiliation":[{"name":"University Hospital of Basel","place":["Basel, Switzerland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Albert J.","family":"Yoo","sequence":"additional","affiliation":[{"name":"Texas Stroke Institute","place":["Dallas\u2010Fort Worth, United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ludo F.M.","family":"Beenen","sequence":"additional","affiliation":[{"name":"Amsterdam UMC, University of Amsterdam","place":["Amsterdam, The Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefan D.","family":"Roosendaal","sequence":"additional","affiliation":[{"name":"Amsterdam UMC, University of Amsterdam","place":["Amsterdam, The Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maxim J.H.L.","family":"Mulder","sequence":"additional","affiliation":[{"name":"Erasmus Medical Center","place":["Rotterdam, The Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jasper M.","family":"Martens","sequence":"additional","affiliation":[{"name":"Rijnstate Hospital","place":["Arnhem, The Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alida A.","family":"Postma","sequence":"additional","affiliation":[{"name":"Maastricht University Medical Center","place":["Maastricht, The Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diederik W.J.","family":"Dippel","sequence":"additional","affiliation":[{"name":"Erasmus Medical Center","place":["Rotterdam, The Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wim H.","family":"van Zwam","sequence":"additional","affiliation":[{"name":"Maastricht University Medical Center","place":["Maastricht, The Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olvert A.","family":"Berkhemer","sequence":"additional","affiliation":[{"name":"Amsterdam UMC, University of Amsterdam","place":["Amsterdam, The Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henk A.","family":"Marquering","sequence":"additional","affiliation":[{"name":"Amsterdam UMC, University of Amsterdam","place":["Amsterdam, The Netherlands"]},{"name":"Amsterdam UMC, University of Amsterdam","place":["Amsterdam, The Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles B.L.M.","family":"Majoie","sequence":"additional","affiliation":[{"name":"Amsterdam UMC, University of Amsterdam","place":["Amsterdam, The Netherlands"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"the MR CLEAN Registry Investigators","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)00163-X"},{"key":"e_1_3_2_3_2","doi-asserted-by":"crossref","DOI":"10.1161\/STR.0000000000000211","article-title":"Guidelines for the early management of patients with acute ischemic stroke: 2019 update to the 2018 guidelines for the early management of acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association\/American Stroke Association","volume":"50","author":"Powers WJ","year":"2019","unstructured":"Powers WJ, Rabinstein AA, Ackerson T, Adeoye OM, Bambakidis NC, Becker K, Biller J, Brown M, Demaerschalk BM, Hoh B, et\u00a0al. 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