Study suggests that it may be reasonable to select patients for thrombectomy in centres without access to advanced imaging using the e-ASPECTS tool in combination with clinical criteria.

Oxford – Patients with large vessel occlusion stroke, presenting at an unknown time from symptom onset or beyond 6 hours, may be selected for mechanical thrombectomy based on e-ASPECTS and clinical criteria alone.

Current guidelines necessitate advanced imaging such CTP or MR perfusion, but a new study shows that e-ASPECTS-based selection as the sole imaging criterion for late time window patients resulted in similar outcomes to those seen in trials which used advanced imaging for patient selection.

This study suggests that it may be reasonable to select patients for thrombectomy in centres without access to advanced imaging using the e-ASPECTS tool in combination with clinical criteria. It also raises the possibility that patients are being over selected by current guideline-based criteria, and that the clinical – e-ASPECTS mismatch approach would provide access to this life saving intervention for more patients. This study provides further evidence that e-ASPECTS is a reliable and valuable tool in the selection of patients for thrombectomy, saving valuable time, providing objective identification of ischaemic injury and empowering clinicians when selecting patients for intervention.

Dr George Harston, Chief Medical and Innovation Officer, Brainomix & Consultant Physician, Oxford University Hospitals NHSFT stated: “This important study highlights the potential of the Brainomix e-ASPECTS support tool to simplify the selection of stroke patients for thrombectomy presenting in the late time window. The findings suggest that access to thrombectomy may be broadened to a wider population of patients, and without need for time consuming advanced imaging, which is often not readily available even in larger centres.”

The results of this study have been published here