Functional outcomes and quality of life after endovascular thrombectomy in large and extensive infarcts (ASPECTS 0–5): a multicentre registry study

Figures

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  Figure 1. Cohort flow. Patients from the GSR-ET were screened for baseline ASPECTS 0–5, anterior-circulation ICA/M1/M2 occlusion, EVT and available 90-day mRS after carrying forward in-hospital death. ASPECTS 0–2 was defined as extensive infarct and ASPECTS 3–5 as large infarct. No patient with an ASPECTS of 0 was included, so the extensive-infarct group comprises patients with ASPECTS 1–2. Abbreviations: ASPECTS = Alberta Stroke Program Early CT Score; GSR-ET = German Stroke Registry-Endovascular Treatment; ICA = internal carotid artery.

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  Figure 2. Distribution of 90-day functional outcome (mRS). (A) By infarct group; (B) by reperfusion success; (C) by 24-h NIHSS. Each bar shows the percentage in each mRS category, and connecting bands link the same mRS category between adjacent bars.

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  Figure 3. Functional outcome by infarct group and reperfusion success. (A) Proportion of patients with 90-day mRS 0–3 by infarct group and final reperfusion status, restricted to patients with premorbid mRS ≤ 3 and available final mTICI (n = 802: 76 with ASPECTS 1–2 and 726 with ASPECTS 3–5). Each cell shows the mRS 0–3 percentage, the cell denominator and 90-day mortality; the panel is descriptive and unadjusted. (B) Adjusted marginal probabilities of mRS 0–3 among patients with premorbid mRS ≤ 3 and complete model covariates (n = 755), from a logistic regression model with the covariates of model 2 (infarct group, successful reperfusion, age, sex, admission NIHSS, premorbid mRS, occlusion site, imaging modality, admission-to-groin time and IV thrombolysis). Error bars indicate 95% CIs calculated by the delta method using conventional, non-clustered standard errors. Successful reperfusion was defined as final mTICI 2b–3. Abbreviations: ASPECTS = Alberta Stroke Program Early CT Score; mTICI, modified thrombolysis in cerebral infarction.

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  Figure 4. Quality of life and living condition after EVT. (A) EQ-5D utility index at 90 days among surviving patients with an available utility index (n = 27 of 40 survivors with ASPECTS 1–2 and n = 324 of 437 with ASPECTS 3–5). (B) Living condition at 90 days among surviving patients with documented living status (n = 33 of 40 survivors with ASPECTS 1–2 and n = 411 of 437 with ASPECTS 3–5). The number of patients with available data is given below each group label. Abbreviations: ASPECTS = Alberta Stroke Program Early CT Score; EQ-5D = European Quality of Life-5 Dimensions.