ArticleJAMA neurology2024
Alberta Stroke Program Early Computed Tomography Score, Infarct Core Volume, and Endovascular Therapy Outcomes in Patients With Large Infarct: A Secondary Analysis of the ANGEL-ASPECT Trial.
Article in JAMA neurology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04551664 (Study of Endovascular Therapy in Acute Anterior Circulation Large Vessel Occlusive Patients With a Large Infarct Core), which is not on this map. Cited by 20 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Study of Endovascular Therapy in Acute Anterior Circulation Large Vessel Occlusive Patients With a Large Infarct Core: A Multi-centered, Prospective, Open-label, Blind Endpoint， Randomized Controlled Trial（ANGEL-ASPECT）
Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Endovascular Thrombectomy for Large Ischemic Strokes with ASPECTS 0-2: a Meta-analysis of Randomized Controlled Trials.Clinical neuroradiology · 2024Pooled it
- White matter lesions modifying endovascular therapy outcomes in large ischemic core stroke: A secondary analysis of the ANGEL-ASPECT trial.Chinese medical journal · 2026Trial
- Safety and clinical outcomes of endovascular therapy versus medical management in late presentation of large ischemic stroke.European stroke journal · 2024Trial
- Refined AI-ASPECTS with modified atlas and lesion-load thresholds: advancing acute ischemic stroke imaging and prognostic prediction.BMC medicine · 2026Article
- Delayed M1 Dissection After Thrombectomy Treated With Rescue Stenting and Tirofiban: A Case Report.Cureus · 2026Article
- Cost Effectiveness of Endovascular Thrombectomy for Large Ischemic Strokes: A US Healthcare Payer Markov Model Informed by Randomized Trials.Applied health economics and health policy · 2026Article
- Combined ipsilateral peak systolic velocity and ASPECTS are associated with early neurological deterioration after endovascular thrombectomy: a prospective cohort study.BMC neurology · 2026Article
- Impact of enlarged perivascular spaces on endovascular therapy outcomes in patients with large ischaemic core: A post-hoc analysis of the ANGEL-ASPECT trial.Journal of translational internal medicine · 2026Article
- Generative Artificial Intelligence to Automate Cerebral Perfusion Mapping in Acute Ischemic Stroke from Non-contrast Head Computed Tomography Images: Pilot Study.Journal of imaging informatics in medicine · 2026Article
- Edaravone Dexborneol in Large Ischemic Stroke: Real-World Experience from a Multicenter Study in China.Journal of the American Heart Association · 2026Observational
- Clinical correlates, procedural benchmarks, and reperfusion-outcome dissociation after mechanical thrombectomy for acute large-vessel occlusion stroke: a single-center retrospective registry study.Frontiers in neurology · 2026Observational
- Large Core Trial.AJNR. American journal of neuroradiology · 2025Review
- Anticoagulation therapy after reperfusion treatment for acute ischemic stroke with non-valvular atrial fibrillation: a multicenter retrospective study.Scientific reports · 2025Article
- Early venous filling is associated with unfavorable outcomes in acute ischemic stroke with large vessel occlusion after mechanical thrombectomy: a real-world analysis.BMC neurology · 2025Article
- Does Ischemic Core Volume Modify the Treatment Effect of Endovascular Thrombectomy?Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2024Article
- CLEAR Thrombectomy Score: An Index to Estimate the Probability of Good Functional Outcome With or Without Endovascular Treatment in the Late Window for Anterior Circulation Occlusion.Journal of the American Heart Association · 2024Observational
- Exploring the Limits of Endovascular Therapy for Large Core Patients: Where Do We Need More Data?Stroke · 2024Article
- Noncontrast CT Selected Thrombectomy vs Medical Management for Late-Window Anterior Large Vessel Occlusion.Neurology · 2024Article
- Value of Multimodal Computed Tomography Quantitative Analysis for Predicting Early Neurological Deterioration in Acute Ischemic Stroke Patients Undergoing Intravenous Thrombolysis.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/HemostasisArticle
- Net water uptake and ASPECTS in predicting futile recanalization for acute large vessel occlusion stroke: insights from time window stratification.Frontiers in neurologyArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
14 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Importance: Endovascular therapy (EVT) demonstrated better outcomes compared with medical management in recent randomized clinical trials (RCTs) of patients with large infarct. Objective: To compare outcomes of EVT vs medical management across different strata of the Alberta Stroke Program Early Computed Tomography Score (ASPECTS) and infarct core volume in patients with large infarct. Design, Setting, and Participants: This prespecified secondary analysis of subgroups of the Endovascular Therapy in Acute Anterior Circulation Large Vessel Occlusive Patients With a Large Infarct Core (ANGEL-ASPECT) RCT included patients from 46 stroke centers across China between October 2, 2020, and May 18, 2022. Participants were enrolled within 24 hours of symptom onset and had ASPECTS of 3 to 5 or 0 to 2 and infarct core volume of 70 to 100 mL. Patients were divided into 3 groups: ASPECTS of 3 to 5 with infarct core volume less than 70 mL, ASPECTS of 3 to 5 with infarct core volume of 70 mL or greater, and ASPECTS of 0 to 2. Interventions: Endovascular therapy or medical management. Main Outcomes and Measures: The primary outcome was the ordinal 90-day modified Rankin Scale (mRS) score. Results: There were 455 patients in the trial; median age was 68 years (IQR, 60-73 years), and 279 (61.3%) were male. The treatment effect did not vary significantly across the 3 baseline imaging subgroups (P = .95 for interaction). The generalized odds ratio for the shift in the 90-day mRS distribution toward better outcomes with EVT vs medical management was 1.40 (95% CI, 1.06-1.85; P = .01) in patients with ASPECTS of 3 to 5 and infarct core volume less than 70 mL, 1.22 (95% CI, 0.81-1.83; P = .23) in patients with ASPECTS of 3 to 5 and infarct core volume of 70 mL or greater, and 1.59 (95% CI, 0.89-2.86; P = .09) in patients with ASPECTS of 0 to 2. Conclusions and Relevance: In this study, no significant interaction was found between baseline imaging status and the benefit of EVT compared with medical management in patients with large infarct core volume. However, estimates within subgroups were underpowered. A pooled analysis of large core trials stratified by ASPECTS and infarct core volume strata is warranted. Trial Registration: ClinicalTrials.gov Identifier: NCT04551664.
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