An ASPECTS score of less than 6 indicates what?

• A. Extensive infarct and tissue damage; patient would not benefit from mechanical thrombectomy, may be harmful
• B. No infarct; proceed with thrombectomy
• C. Small infarct; surgery recommended
• D. Moderate infarct; consider therapy

Answer: (A)

ASPECTS is a 10-point CT score that estimates the extent of early ischemic changes in the MCA territory. Each region that looks normal adds a point; early changes subtract a point. A score under 6 signals extensive infarct and tissue damage, meaning most of the affected brain area is already irreversibly damaged with little salvageable tissue. In this situation, mechanical thrombectomy is unlikely to provide a meaningful benefit and may pose risks such as bleeding or harm without improving outcome. So, when the ASPECTS score is less than 6, the best interpretation is that extensive infarct favors not pursuing thrombectomy.