Abstract A031: Non-Contrast CT Severe Hypodensity versus Net Water Uptake in Assessing Thrombectomy Treatment Effect in Large Core Stroke: A Secondary Analysis of the SELECT2 Trial

Introduction: Severe CT-hypodensity, representing blood-brain-barrier (BBB) injury, has been shown to modify endovascular therapy (EVT) treatment effect in patients presenting with large core stroke. Net water uptake (NWU), reflecting average hypodensity within the lesion, is another measure of BBB injury and has been shown to be prognostic of poor outcome, but whether it modifies EVT treatment effect is unclear. Methods: We performed a comparative analysis of severe CT-hypodensity and NWU in patients enrolled into SELECT2, a randomized trial of EVT and medical management (MM) in patients with large core stroke (ASPECTS 3-5 or CTP core ≥50ml). Visible CT-hypodensity was manually outlined on baseline imaging. Severe CT-hypodensity was defined as the volume of core voxels