E-024 Aspiration thrombectomy on acute ischemic stroke patients with a low alberta stroke program early computerized tomography score
Bibliographic record
Abstract
Introduction/Purpose For patients who receive endovascular therapy for acute ischemic stroke (AIS), a lower Alberta Stroke Program Early CT Score (ASPECTS) correlates with worse outcomes. However, AIS patients with a low ASPECTS may still have a better outcome after endovascular therapy than after best medical therapy. The purpose of this study was to determine the outcome of AIS patients with a low ASPECTS who undergo aspiration thrombectomy. Materials and Methods This is a subset analysis of a global prospective multicenter registry (COMPLETE) that enrolled adults with large vessel occlusion AIS and a pre-stroke mRS of 0-1 who underwent first-line aspiration thrombectomy with the Penumbra System. Data for patients with ASPECTS 2-5 were compared across lower and higher ASPECTS, patient age, baseline collateral flow (ASITN/SIR grade), and time to puncture groups. Results Of the 650 patients enrolled, 73 had ASPECTS 2-5. No significant difference was detected between ASPECTS 2-3 and ASPECTS 4-5, ≤ 80 and > 80 years old, collateral flow groups, or ≤ 6 and > 6 hours to puncture for rates of mTICI 2b-3 post-procedure, mRS 0-2 at 90 days, or symptomatic ICH at 24 hours. All-cause mortality rate at 90 days was significantly higher for ASPECTS 2-3 than for ASPECTS 4-5. There was a trend for higher sICH for time to puncture > 6 hours (p=0.09). mRS 0-2 at 90 days was achieved in only 18.8% of patients with ASITN 0-1 and in no patients > 80 years old. Conclusion Even in AIS patients with low ASPECTS, aspiration thrombectomy treatment can achieve a good functional outcome in some patients and should be considered. Disclosures J. Fifi: 1; C; Microvention, Penumbra, Stryker. 2; C; Microvention, Stryker. 4; C; Imperative Care. A. Hassan: 2; C; GE Healthcare, Genentech, Medtronic, Microvention, Penumbra, Stryker, Cerenovus, Viz.ai, Balt, Scientia. 3; C; GE Healthcare, Genentech, Medtronic, Microvention, Penumbra, Stryker, Cerenovus, Viz.ai, Balt, Scientia. O. Zaidat: 1; C; Genentech, Medtronic Neurovascular, Stryker. 2; C; Codman, Medtronic Neurovascular, National Institutes of Health StrokeNet, Penumbra, Stryker. 4; C; Galaxy Therapeutics, Inc.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".