{
  "abstract": "Introduction Randomized controlled trials have demonstrated the safety and efficacy of mechanical thrombectomy (MT) in large core strokes (LCS; ASPECTS 0–5). However, data on very large core strokes (vLCS; ASPECTS 0–2) remain limited.Aim of Study To evaluate the outcome of patients treated with MT within 24 hours in ASPECTS 0–2 compared to those with CTS 3–5.Method We conducted a retrospective review of patients with anterior circulation LCS who underwent EVT within 24 hs of symptom onset at our center between 2015–2025, with a minimum 90-day follow-up. Patients were dichotomized into ASPECTS 0–2 vs. 3–5 groups. We evaluated the modified Rankin Scale (mRS), mRS ≤3 and mortality at 90-day and symptomatic intracranial hemorrhage (sICH) within 48 hs.Results 150 patients were included, 33 with ASPECTS 0–2. This subgroup had higher baseline NIHSS scores (20.9±6.9 vs. 17.6±5.8, p=0.0006), increased sICH rates (46% vs 17%, p=0.001), lower rates of TICI 2b-3 (61% vs 84%, p= 0.004), worse 90-day mRS (5.3±1.3 vs. 4.1±2.0, p=0.001), lower rates of mRS ≤3 (6% vs. 38%, p=0.001), and higher 90-day mortality (67% vs. 39%, p=0.004). .Full results are showed in table 1.Abstract A273 Table 1Conclusion Patients with vLCS had significantly worse outcomes, higher mortality, increased sICH, and lower rates of functional independence compared to those with ASPECTS 3–5. These findings may suggest a potential ceiling effect in core volume infarct beyond which EVT may have limited benefit, that finding must be investigated.Conflict of Interest No",
  "authors": [
    {
      "affiliations": [
        "Clinica Sagrada Familia-ENERI, Ciudad Autonoma de Buenos Aires, Argentina"
      ],
      "name": "Julieta Rosales"
    },
    {
      "affiliations": [
        "Clinica Sagrada Familia-ENERI, Ciudad Autonoma de Buenos Aires, Argentina"
      ],
      "name": "Juan Cirio"
    },
    {
      "affiliations": [
        "Clinica Sagrada Familia-ENERI, Ciudad Autonoma de Buenos Aires, Argentina"
      ],
      "name": "Matias Lopez"
    },
    {
      "affiliations": [
        "Clinica Sagrada Familia-ENERI, Ciudad Autonoma de Buenos Aires, Argentina"
      ],
      "name": "David Freire"
    },
    {
      "affiliations": [
        "Clinica Sagrada Familia-ENERI, Ciudad Autonoma de Buenos Aires, Argentina"
      ],
      "name": "Laura Caballero"
    },
    {
      "affiliations": [
        "Clinica Sagrada Familia-ENERI, Ciudad Autonoma de Buenos Aires, Argentina"
      ],
      "name": "Manuel Chasco"
    },
    {
      "affiliations": [
        "Clinica Sagrada Familia-ENERI, Ciudad Autonoma de Buenos Aires, Argentina"
      ],
      "name": "Nicolas Perez"
    },
    {
      "affiliations": [
        "Clinica Sagrada Familia-ENERI, Ciudad Autonoma de Buenos Aires, Argentina"
      ],
      "name": "Esteban Scrivano"
    },
    {
      "affiliations": [
        "Clinica Sagrada Familia-ENERI, Ciudad Autonoma de Buenos Aires, Argentina"
      ],
      "name": "Carlos Bleise"
    },
    {
      "affiliations": [
        "Clinica Sagrada Familia-ENERI, Ciudad Autonoma de Buenos Aires, Argentina"
      ],
      "name": "Pedro Nicolas Lylyk"
    },
    {
      "affiliations": [
        "Clinica Sagrada Familia-ENERI, Ciudad Autonoma de Buenos Aires, Argentina"
      ],
      "name": "Ivan Lylyk"
    },
    {
      "affiliations": [
        "Clinica Sagrada Familia-ENERI, Ciudad Autonoma de Buenos Aires, Argentina"
      ],
      "name": "Lylyk Pedro"
    }
  ],
  "title": "A273 Very large core strokes in real life: is there a ceiling effect?",
  "uid": "71e15257-a1aa-5269-a944-ed990091638c"
}