Endovas cular treatment in acute is chemic s troke

초록

The Alberta Stroke Program Early CT Score (ASPECTS) is widely used as a method to evaluate the range of early ischemic change in acute cerebral infarction,1 and in the American Heart Association guideline 2018,2 endovascular therapy (EVT) is strongly recommended for acute cerebral large vessel occlusion (LVO) with ASPECTS ≥6 (6?10) due to occlusion of the internal carotid artery (ICA) or M1 segment of the middle cerebral artery (M1) as class of recommendation I.2 But the benefits of EVT for patients with ASPECTS ≤5 (0?5) are uncertain, so it is recommended only as class of recommendation IIb in that guideline. In real world, EVT is sometimes performed for the patients with ASPECTS 0 to 5 because even if the early ischemic change is wide, EVT may be effective if the penumbra area is wide.3 However, reperfusion therapy for patients with large ischemic core may increase the risk of intracranial hemorrhage. In many previous randomized controlled trials (RCTs), patients with large ischemic core were excluded. For example,