Key result
EVT improves functional outcomes over medical therapy alone only in large core strokes with NWU <15%.
Why the study?
Does endovascular thrombectomy improve functional outcomes compared to best medical therapy alone in patients with low ASPECTS stroke, and is this effect modified by net water uptake on CT?
RCT
Does endovascular thrombectomy improve functional outcomes compared to best medical therapy alone in patients with low ASPECTS stroke, and is this effect modified by net water uptake on CT?
p-value: p=<0.002
Net water uptake on admission CT can identify patients with large infarct cores who are most likely to benefit from endovascular thrombectomy.
< .002), suggesting greater treatment efficacy in patients with low NWU. EVT in patients with an NWU of less than 15.0% was associated with a greater probability of achieving an mRS of less than or equal to 3, whereas greater NWU was associated with less effective EVT. Conclusion The degree of NWU at admission CT modified the treatment effect of EVT in patients with large infarct cores. EVT was associated with improved outcomes only in patients with lower NWU, whereas in patients with an NWU of at least 15%, EVT plus BMT did not show a functional benefit over BMT alone. ClinicalTrials.gov Identifier: NCT03094715 © RSNA 2025
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Broocks et al. (2025) conducted an RCT in Low ASPECTS Stroke with large infarct cores. Endovascular thrombectomy (EVT) plus best medical therapy (BMT) vs. Best medical therapy (BMT) alone was evaluated on mRS of less than or equal to 3 (p=<0.002). Endovascular thrombectomy improved functional outcomes (mRS ≤ 3) compared to medical therapy alone only in stroke patients with large infarct cores and net water uptake <15% (P<0.002).
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