BACKGROUND AND PURPOSE: Age and stroke severity are inversely correlated with 
the odds of favorable outcome after ischemic stroke. A previously proposed score 
for Stroke Prognostication Using Age and NIHSS Stroke Scale (SPAN) indicated 
that SPAN-100-positive patients (ie, age + NIHSS score = 100 or more) do not 
benefit from IV-tPA. If this finding holds true for endovascular therapy, this 
score can impact patient selection for such interventions. This study 
investigated whether a score combining age and NIHSS score can improve patients' 
selection for endovascular stroke therapy.
MATERIALS AND METHODS: The SPAN index was calculated for patients in the 
prospective Solitaire FR Thrombectomy for Acute Revascularization study: an 
international single-arm multicenter cohort for anterior circulation stroke 
treatment by using the Solitaire FR. The proportion with favorable outcome 
(90-day mRS score ≤2) was compared between SPAN-100-positive versus-negative 
patients.
RESULTS: Of the 202 patients enrolled, 196 had baseline NIHSS scores. Fifteen 
(7.7%) patients were SPAN-100-positive. There was no difference in the rate of 
successful reperfusion (Thrombolysis In Cerebral Infarction 2b or 3) between 
SPAN-100-positive versus -negative groups (93.3% versus 82.8%, respectively; P = 
.3). Stroke SPAN-100-positive patients had a significantly lower proportion of 
favorable clinical outcomes (26.7% versus 60.8% in SPAN-100-negative, P = .01). 
In a multivariable analysis, SPAN-100-positive status was associated with lower 
odds of favorable outcome (OR, 0.3; 95% CI, 0.1-0.9; P = .04). A higher baseline 
Alberta Stroke Program Early CT Score and a short onset to revascularization 
time also predicted favorable outcome in the multivariable analysis.
CONCLUSIONS: A significantly lower proportion of patients with a positive 
SPAN-100 achieved favorable outcome in this cohort. SPAN-100 was an independent 
predictor of favorable outcome after adjusting for time to treatment and the 
extent of preintervention tissue damage according to the Alberta Stroke Program 
Early CT Score.