Deans' stroke musings: Combined assessment of ASPECTS and collateral status predict outcomes after endovascular therapy in patients with large ischemic stroke

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Monday, September 14, 2026

Combined assessment of ASPECTS and collateral status predict outcomes after endovascular therapy in patients with large ischemic stroke

'Assessments' NEVER GET YOU RECOVERED! You need EXACT PROTOCOLS for that, and this doesn't do that; SO FUCKING USELESS!

I'll assess your comeuppance/screaming when you are the 1 in 4 per WHO that has a stroke will be soul satisfying.

Combined assessment of ASPECTS and collateral status predict outcomes after endovascular therapy in patients with large ischemic stroke

Wei Deng 1,2
Z
Zhengqiao Bao 2
J
Jun Han 2
Y
Yanli Sun 3,4
P
Peiyang Zhou 2*
Guangxian Nan 1*

1. Department of Neurology, China-Japan Union Hospital of Jilin University, Changchun, Jilin, China
2. Department of Neurology, Xiangyang No. 1 People’s Hospital, Hubei University of Medicine, Xiangyang, Hubei, China

Abstract

Background:

Both the Alberta Stroke Program Early Computed Tomography Score (ASPECTS) and collateral status are well-established predictors of clinical outcomes in patients with large ischemic stroke undergoing endovascular therapy (EVT); however, they have traditionally been assessed independently. This study aimed to evaluate the prognostic value of a combined imaging score, the AS-TCIS score, which integrates ASPECTS and collateral status into a unified framework.

Methods:

This study is a subanalysis of a prospective multicenter cohort including patients with ASPECTS ≤5 enrolled between November 2021 and February 2023. The AS-TCIS score was constructed by integrating the 5-point ASPECTS with collateral status, including the 3-point Tan score and the 8-point comprehensive venous outflow (CVO) score, yielding a 16-point composite scale. The primary outcomes were 90-day functional outcome (modified Rankin Scale [mRS] 0–3) and mortality.

Results:

Of 750 patients, 287 were eligible (median age 67 years; 58.5% male; median AS-TCIS score 8). In multivariable models, each 1-point increase in AS-TCIS was associated with higher odds of mRS 0–3 (OR 1.38; 95% CI 1.24–1.56) and mRS 0–2 (OR 1.30; 95% CI 1.17–1.47), and lower odds of mortality (OR 0.74; 95% CI 0.66–0.82), with no significant association with symptomatic intracranial hemorrhage (OR 0.92; 95% CI 0.82–1.03). AS-TCIS also demonstrated a linear association with functional outcome and mortality. Compared with ASPECTS, Tan score, and their combination, AS-TCIS showed consistently higher AUCs and improved model fit across all outcomes.

Conclusion:

The AS-TCIS score, a composite of ASPECTS and collateral status, was independently associated with 90-day outcomes in patients with large ischemic stroke undergoing EVT. It may provide incremental value for risk stratification and outcome prediction in acute stroke imaging assessment.