{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T05:09:44Z","timestamp":1789016984289,"version":"build-2803163510"},"reference-count":34,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:00:00Z","timestamp":1788998400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Both the Alberta Stroke Program Early Computed Tomography Score (ASPECTS) and collateral status are well-established predictors of clinical outcomes in patients with large ischemic stroke undergoing endovascular therapy (EVT); however, they have traditionally been assessed independently. This study aimed to evaluate the prognostic value of a combined imaging score, the AS-TCIS score, which integrates ASPECTS and collateral status into a unified framework.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study is a subanalysis of a prospective multicenter cohort including patients with ASPECTS \u22645 enrolled between November 2021 and February 2023. The AS-TCIS score was constructed by integrating the 5-point ASPECTS with collateral status, including the 3-point Tan score and the 8-point comprehensive venous outflow (CVO) score, yielding a 16-point composite scale. The primary outcomes were 90-day functional outcome (modified Rankin Scale [mRS] 0\u20133) and mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 750 patients, 287 were eligible (median age 67\u202fyears; 58.5% male; median AS-TCIS score 8). In multivariable models, each 1-point increase in AS-TCIS was associated with higher odds of mRS 0\u20133 (OR 1.38; 95% CI 1.24\u20131.56) and mRS 0\u20132 (OR 1.30; 95% CI 1.17\u20131.47), and lower odds of mortality (OR 0.74; 95% CI 0.66\u20130.82), with no significant association with symptomatic intracranial hemorrhage (OR 0.92; 95% CI 0.82\u20131.03). AS-TCIS also demonstrated a linear association with functional outcome and mortality. Compared with ASPECTS, Tan score, and their combination, AS-TCIS showed consistently higher AUCs and improved model fit across all outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The AS-TCIS score, a composite of ASPECTS and collateral status, was independently associated with 90-day outcomes in patients with large ischemic stroke undergoing EVT. It may provide incremental value for risk stratification and outcome prediction in acute stroke imaging assessment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2026.1887827","type":"journal-article","created":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T04:29:02Z","timestamp":1789014542000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Combined assessment of ASPECTS and collateral status predict outcomes after endovascular therapy in patients with large ischemic stroke"],"prefix":"10.3389","volume":"17","author":[{"given":"Wei","family":"Deng","sequence":"first","affiliation":[{"name":"Department of Neurology, China-Japan Union Hospital of Jilin University","place":["Changchun, Jilin, China"]},{"name":"Department of Neurology, Xiangyang No. 1 People\u2019s Hospital, Hubei University of Medicine","place":["Xiangyang, Hubei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhengqiao","family":"Bao","sequence":"additional","affiliation":[{"name":"Department of Neurology, Xiangyang No. 1 People\u2019s Hospital, Hubei University of Medicine","place":["Xiangyang, Hubei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Neurology, Xiangyang No. 1 People\u2019s Hospital, Hubei University of Medicine","place":["Xiangyang, Hubei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanli","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of General Practice, Xiangyang No. 1 People\u2019s Hospital, Hubei University of Medicine","place":["Xiangyang, Hubei, China"]},{"name":"Department of Endocrinology, The First Affiliated Hospital of Anhui Medical University","place":["Hefei, Anhui, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peiyang","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Neurology, Xiangyang No. 1 People\u2019s Hospital, Hubei University of Medicine","place":["Xiangyang, Hubei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guangxian","family":"Nan","sequence":"additional","affiliation":[{"name":"Department of Neurology, China-Japan Union Hospital of Jilin University","place":["Changchun, Jilin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,10]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"708","DOI":"10.1056\/NEJMoa1713973","article-title":"Thrombectomy for stroke at 6 to 16 hours with selection by perfusion imaging","volume":"378","author":"Albers","year":"2018","journal-title":"N Engl J 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