Journal Article

DZNE-2026-01138

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Functional outcomes and quality of life after endovascular thrombectomy in large and extensive infarcts (ASPECTS 0-5): a multicentre registry study.

Asperger, H. (First author)DZNE* ; Bode, F. J.Extern* ; Ebrahimi, T.DZNE* ; Klehr, L.Extern* ; Layer, J.DZNE* ; Meißner, J. ; Nitsch, L. ; Shirvani, O.DZNE* ; Thielscher, C. S.DZNE* ; von Danwitz, N. M.DZNE* ; Odensaß, S. ; Stösser, S.Extern* ; Dorn, F. ; Petzold, G. C.DZNE* ; Weller, J. ; Investigators, G.-E. (Collaboration Author)

2026
Sage Publishing London

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Please use a persistent id in citations: doi:10.1093/esj/aakag131

Abstract: Endovascular thrombectomy (EVT) is established for large infarcts, but remains cautiously applied in extensive infarcts with an Alberta Stroke Program Early CT Score (ASPECTS) of 0-2. Real-life outcome data remain limited.Retrospective analysis of the German Stroke Registry-Endovascular Treatment comparing extensive (ASPECTS 0-2) and large infarcts (ASPECTS 3-5) in patients with anterior-circulation occlusion and EVT. The primary outcome was the ordinal 90-day mRS distribution; secondary outcomes were mRS 0-3, survival, quality of life (3-level European Quality of Life-5 Dimensions) and living condition.Of 18,069 screened patients, 889 were analysed (ASPECTS 1-2, n = 89; ASPECTS 3-5, n = 800); none had ASPECTS 0. With ASPECTS 1-2, 20.2% achieved mRS 0-3 and 55.1% died within 90 days. In the model including successful reperfusion, no statistically significant association was detected between infarct group and the 90-day mRS distribution (common odds ratio [cOR] 0.80; 95% CI, 0.53-1.23) or mRS 0-3 (adjusted odds ratio [aOR] 0.89; 95% CI, 0.64-1.25), whereas successful reperfusion was associated with both (cOR 3.68; 95% CI, 2.31-5.85 and aOR 4.10; 95% CI, 2.45-6.86). Among survivors, median European Quality of Life-5 Dimensions utility index was 0.445 vs 0.541 (n = 27/324), and 51.5% vs 50.9% lived at home (n = 33/411).An extensive infarct carried a challenging prognosis, yet acceptable outcome and non-institutional living remained achievable in a relevant minority. An independent association of infarct group with outcome was not detected.An acceptable outcome remained attainable in selected patients with extensive infarction, particularly after successful reperfusion. Lacking a medically managed comparator, these data describe prognosis rather than treatment effect.

Keyword(s): Humans (MeSH) ; Quality of Life (MeSH) ; Thrombectomy: methods (MeSH) ; Registries (MeSH) ; Female (MeSH) ; Endovascular Procedures: methods (MeSH) ; Male (MeSH) ; Aged (MeSH) ; Retrospective Studies (MeSH) ; Treatment Outcome (MeSH) ; Aged, 80 and over (MeSH) ; Middle Aged (MeSH) ; Stroke: surgery (MeSH) ; X-ray computed ; cerebral infarction ; endovascular procedures ; patient selection ; quality of life ; registries ; thrombectomy ; tomography ; treatment outcome

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Contributing Institute(s):

1. Clinical Research Platform (CRP) (AG Spottke)
2. Vascular Neurology (AG Petzold)
3. Clinical Single Cell Omics (CSCO) / Systems Medicine (AG Schultze)
4. Clinical Research Platform (CRP) (Clinical Research Platform (CRP))

Research Program(s):

1. 353 - Clinical and Health Care Research (POF4-353) (POF4-353)
2. 354 - Disease Prevention and Healthy Aging (POF4-354) (POF4-354)

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Database coverage:
; Clarivate Analytics Master Journal List ; Current Contents - Clinical Medicine ; Essential Science Indicators ; IF >= 5 ; JCR ; National-Konsortium ; PubMed Central ; SCOPUS ; Science Citation Index Expanded ; Web of Science Core Collection

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