Pittsburgh Response to Endovascular therapy (PRE) Score
Identifies patients with anterior circulation large vessel occlusion (LVO) strokes likely to benefit from endovascular therapy.
Use in patients ≥18 years old, presenting within 8 hours of symptom onset, with anterior circulation (i.e., internal carotid, M1, or M2) LVO stroke. Measure ASPECTS using most recent CT imaging data. Apply with caution to patients with baseline morbidities.
Management
- Patients with PRE Score -24 to +49 are likely to derive the maximum benefit from endovascular reperfusion therapy if successful revascularization, i.e. TICI (Thrombolysis In Cerebral Infarction) grade 2b/3, is achieved.
- Patients with PRE Score ≥50 are least likely to benefit from endovascular therapy. Rate of good outcome (mRS 0-2) or final infarct size was not affected by TICI grade 2b/3 reperfusion in the PRE Score ≥50 group.
Critical Actions
Use the PRE Score as an adjunct to clinical judgment, not a replacement.