The effect of CT-ASPECT localization, infarct volume in DWI-MR and collateral circulation CTA on clinical outcome in patients with ischemic stroke receiving endovasculer thrombectomy treatment

Objective: Acute ischemic stroke is an important clinical picture that leads to mortality and morbidity. In acute ischemic stroke, the evaluation of patients using appropriate imaging methods is important in terms of diagnosis, treatment options and clinical course. In light of this information, it aims to evaluate the relationship between pre-procedure CT-ASPECT lesion localization, DWI-MR infarct volume and mCTA collateral circulation and clinical outcome in patients with ICA, MCA M1 occlusion who presented with acute ischemic stroke and underwent EVT. Materials and Methods: In the study, patients who underwent EVT due to acute ischemic stroke at AİBÜ İzzet Baysal Training and Research Hospital between January 2019 and July 2023 were retrospectively evaluated and recorded in terms of demographic characteristics, NIHSS, CT-ASPECT score and infarct localization, infarct volume in DWI-MRI, pre-procedure mCTA collateral circulation, post-procedure recanalization rates and 3rd month mRS. IBM SPSS V23 program was used for statistical analysis of the data and statistical significance value was accepted as 'p<0.05'. Findings: In the study, successful recanalization was achieved in 83 of 100 patients who underwent EVT. 58 of the patients had good clinical outcome and 48 had poor clinical outcome. Higher ASPECT score was associated with good clinical outcome. Patients with capsule interna lesion on CT-ASPECT, higher infarct volume on DWI-MR, and poor mCTA collateral score were associated with poor clinical outcome. Conclusion: Radiological data such as affected localization on CT-ASPECT, infarct volume on DWI-MR, and collateral circulation on mBTA can be used to predict outcomes in AIS patients undergoing EVT. However, comprehensive studies are needed to predict clinical outcome with these data and to make correct EVT decisions in akut ischemik stroke patients. KEYWORDS: Endovascular thrombectomy, CT-ASPECT localization, infarct volüme in DWI-MRI, collateral cırculation by CTA