| Summary: | Objective In acute ischemic stroke (AIS), the low density range of non-contrast computed tomography (NCCT) is larger than that of cerebral blood volume (CBV) from time to time, and there is a mismatch between them. The study aimed to study the safety and efficacy of endovascular treatment (ET) in the patients with NCCT-CBV Alberta stroke program early CT score (ASPECTS) < 0 (N-C < 0) and explore the role of related predictors in the prognosis. Methods Clinical data of 290 consecutive patients with anterior circulation intracranial vascular occlusion undergoing ET in our hospital from January 2015 to August 2018 were collected to conduct a retrospective study. According to N-C score, they were divided into N-C < 0 and N-C>0 groups. The safety outcome were assessed by 90 days of death, severe intracranial hemorrhage, symptomatic intracranial hemorrhage (sICH), and the efficacy outcome included National Institutes of Health Stroke Scale (NIHSS) score at day 7 or discharge, and good functional outcome (mRS≤2) at day 90. The differences between the N-C < 0 and ≥0 groups were compared, and the related predictors for good prognosis were explored by multivariate logistic regression analysis. Results A total of 144 patients were eligible for our inclusion criteria, of 25 in the N-C < 0 group and 119 in the N-C≥0 group. The N-C < 0 group had lower NCCT ASPECTS than the other group (6.96±1.77 vs 8.73±1.25, P < 0.001). Meanwhile, significant differences were seen in the classification of vessels (P=0.036) and the time from puncture to recanalization (P=0.017) between the 2 groups. There were no significant differences in safety and efficacy between the 2 groups. Multivariate regression model showed that CBV ASPECTS (P=0.010, OR=1.460, 95%CI=1.095~1.945) was an independent predictor for good prognosis. Conclusion The patients with N-C < 0 are benefited from ET without increasing risk of intracranial hemorrhage. The low-density lesions of NCCT should not be used as a criterion for excluding or judging the poor functional outcome of ET, but should be further evaluated according to CBV images.
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