Abstract
Abstract TMP67: Predictors Of Unfavourable Events Despite Successful Mechanical Thrombectomy In The Extended Window
Stroke (1970), Vol.53(Suppl_1), p.ATMP67
02/2022
DOI: 10.1161/str.53.suppl_1.TMP67
Abstract
Background:
Futile recanalization (FR) and symptomatic intracranial hemorrhage (sICH) are adverse outcomes after otherwise successful mechanical thrombectomy (MT). The aim of this study was to evaluate independent predictors of these unfavourable events in the extended time window and to compare imaging modalities (non-enhanced CT (NCCT) alone vs. CT perfusion vs. MRI) regarding patient selection.
Methods:
The CT for Late EndovasculAr Reperfusion (CLEAR) study was a multicenter, retrospective study of stroke patients undergoing thrombectomy in the extended time window. The primary endpoint of this study was the proportion of patients with FR, defined as a patient with large vessel occlusion achieving near-complete or complete reperfusion (TICI 2c/3) with a 90-day mRS score between 3 and 6. The secondary safety endpoints included the predictors of mortality and symptomatic intracranial hemorrhage. Inclusion criteria for this analysis were baseline NIHSS ≥6, internal carotid artery, M1 or M2 segment occlusion, prestroke modified rankin scale (pmRS) 0-2, time last seen well (TLSW) to treatment 6-24 hours, and mTICI 2c-3.
Results:
Of 2304 patients in the CLEAR study, 715 patients were included in this analysis. Of these, 364 patients (50.9%) showed FR, 37 patients (5.2%) suffered sICH and 127 patients (17.8%) died within 90 days. Old age, higher baseline NIHSS, higher prestroke disability, transfer to a comprehensive stroke center from another site, and a longer interval from TLSW to puncture were identified as positive predictors of FR. Hypertension was an independent predictor of sICH. The imaging modality (NCCT vs. CT perfusion vs. MRI) was not associated with FR, sICH, or mortality.
Conclusions:
Older age, higher baseline NIHSS, higher prestroke disability, transfer patients, and a longer interval from TLSW to puncture were predictors of FR in the extended window. Hypertension was a predictor of sICH in successfully reperfused patients. Neither MRI or CT perfusion was superior in predicting FR and sICH compared to NCCT alone. NCCT together with CTA may be sufficient for patient selection in the extended time window.
Trial Registration:
ClinicalTrials.gov
Identifier: NCT04096248
Details
- Title: Subtitle
- Abstract TMP67: Predictors Of Unfavourable Events Despite Successful Mechanical Thrombectomy In The Extended Window
- Creators
- Fatih Seker - Univ of Heidelberg, Heidelberg, GermanyMuhammad M Qureshi - Boston Med Cntr, Boston, MAMarkus Möhlenbruch - Univ of Heidelberg, Heidelberg, GermanyRaul G Nogueira - Emory Univ, Atlanta, GAMohamad AbdalKader - Boston Med Cntr, Boston, MAMarc Ribo - HOSPITAL VALL D HEBRON, Barcelona, SpainFrancois Caparros - CHU Lille, Lille, FranceMahmoud Mohammaden - Grady Memorial Hosp, Atlanta, GADiogo C Haussen - EMORY UNIVERSITY SCHOOL OF MEDICINE, Atlanta, GASunil A Sheth - UT Health McGovern, Houston, TXSantiago Ortega-Gutiérrez - University of IowaJames E Siegler - James E Siegler, Philadelphia, PASyed F Zaidi - ProMedica Stroke Network, Toledo, OHMarta Olive-Gadea - Val D'Hebron, Barcelona, SpainHilde Henon - Univ of Lille, Lille, FranceAlicia Castonguay - Toledo, OHStefania Nannoni - Lausanne Univ Hosp, Lausanne, SwitzerlandJohannes Kaesmacher - Radiology, Pediatric and Interventional Neuroradiology, Univ of Bern, Bern, SwitzerlandAjit S Puri - Univ of Massachusetts Med Scho, Weston, MAMudassir Farooqui - University of IowaSergio Salazar-Marioni - UT Health Science Cntr at Texas H, Houston, TXAnna Luisa Kuhn - UMass Med Cntr, Worcester, MANicole Kiley - Boston Med Cntr, Boston, MABehzad Farzin - Cntr Hospier de l'Universite de Montreal, Montreal, CanadaWilliam Boisseau - Cntr Hospier de l'Universite de Montreal, Montreal, CanadaHesham E Masoud - Syracuse Upstate New York, Syracuse, NYCarlos Lopez - Syracuse Upstate New York, Syracuse, NYAmeena Rana - Old Bridge, NJSamer A Abdul Kareem - Mercy Hosp, Toledo, OHAnvitha Sathya - Allentown, NJPiers Klein - Boston, MAMohammad W Kassem - Mercy Hosp, Toledo, OHCharlotte Cordonnier - CHU Lille, Lille, FranceJan Gralla - Bern Univ Hosp, Bern, SwitzerlandUrs M Fischer - UNIVERSITY HOSPITAL BERN, Bern, SwitzerlandPatrik Michel - CHUV, Lausanne, SwitzerlandTudor G Jovin - Cooper Neurological Institute, Camden, NJJean Raymond - Univ of Montreal, Montreal, CanadaOsama Zaidat - Mercy HealthPeter A Ringleb - Univ Hosp Heidelberg, Heidelberg, GermanyThanh N Nguyen - Boston Med Cntr, Boston, MASimon Nagel - Neurology, Univ of Heidelberg, Heidelberg, Germany
- Resource Type
- Abstract
- Publication Details
- Stroke (1970), Vol.53(Suppl_1), p.ATMP67
- DOI
- 10.1161/str.53.suppl_1.TMP67
- ISSN
- 0039-2499
- eISSN
- 1524-4628
- Language
- English
- Date published
- 02/2022
- Academic Unit
- Neurology; Radiology; Iowa Neuroscience Institute; Neurosurgery
- Record Identifier
- 9984303559302771
Metrics
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