Redefining Patient Selection for Endovascular Thrombectomy in Large-Core Ischemic Stroke: The Role of Quantitative Volumetry Beyond ASPECTS

Highlight

– Quantitative volumetry outperforms the Alberta Stroke Program Early Computed Tomography Score (ASPECTS) in prognosticating outcomes after thrombectomy in large-core ischemic stroke.
– A volumetric infarct size threshold of 110 mL demarcates the therapeutic ceiling beyond which thrombectomy’s efficacy is negligible.
– Patients classified as large-core by ASPECTS but without volumetric confirmation do not demonstrate the poor outcomes associated with true large infarct volumes.
– Integration of volumetry into clinical decision-making could minimize futile reperfusion and enhance patient safety.

Study Background