Abstract
Abstract TP193: Impact of Number of Passes on Outcomes of Mechanical Thrombectomy in Stroke Patients With Low ASPECTS
Stroke (1970), Vol.55(Suppl_1)
02/2024
DOI: 10.1161/str.55.suppl_1.TP193
Abstract
Abstract only Introduction: Real-world data showed that less than half of the acute ischemic stroke (AIS) patients with large vessel occlusion (LVO) presenting with low Alberta Stroke Program Early Computed Tomography Score (ASPECTS) (2-5) achieved favorable outcomes at 90 days after mechanical thrombectomy (MT). In this study, we aim to investigate the relationship between the number of MT passes at which successful recanalization is obtained and outcomes in LVO-related AIS patients with low ASPECTS. Methods: This retrospective cohort study was performed on the data from 31 thrombectomy-capable centers between 2013 to 2022. Successful recanalization was defined as modified Thrombolysis in Cerebral Ischemia Score≥ 2b. The primary outcome was a 90-day modified Rankin Scale (mRS) of 0-3. Secondary outcomes were symptomatic intracranial hemorrhage and intracranial hemorrhage within 24 hours and mortality at 90 days. Outcomes were compared among patients with unsuccessful recanalization, and successful recanalization at first, second, third, and more than four passes. Results: A total of 297 patients with a median age of 70 [IQR 59-78] years were included and 140 (47.1%) were female. In 239 (80.4%) patients, successful recanalization was achieved: 88 patients (29.6 %) with 1 pass, 59 patients (19.9 %) with 2 passes, 35 patients(11.8%) with 3 passes, and 57 patients (19.2%) with more than 4 passes. Compared to unsuccessful recanalization, successful recanalization at first pass (adjusted OR 5.25, 95% CI 1.78 - 17.1), second passes (adjusted OR 5.20, 95% CI 1.68 - 17.6), and passes 4 (adjusted OR 4.90, 95% CI 1.68 - 17.6) was related to 90-day mRS 0-3. Recanalization status and MT attempt number were not related to secondary outcomes except for 90-day mortality. Compared to unsuccessful recanalization, successful recanalization at second and third passes were inversely related to 90-day mortality (adjusted OR 0.37, 95% CI 0.14 - 0.93; adjusted OR 0.33, 95% CI 0.11 - 0.95, respectively). Conclusion: The present results indicated that successful recanalization was related to 90-day good outcome regardless of the number of MT passes but the odds of achieving favorable outcome declines with each pass.
Details
- Title: Subtitle
- Abstract TP193: Impact of Number of Passes on Outcomes of Mechanical Thrombectomy in Stroke Patients With Low ASPECTS
- Creators
- Mohammad-Mahdi Sowlat - University of South CarolinaSameh S Elawady - Medical University of South CarolinaHidetoshi Matsukawa - University of CharlestonConor Cunningham - Medical University of South CarolinaAtakan Orscelik - Medical University of South CarolinaSara Zandpazandi - Medical University of South CarolinaNoah Lee Nawabi - University of South CarolinaIlko Maier - Universitätsmedizin GöttingenSami Al Kasab - Medical University of South CarolinaPascal M Jabbour - Thomas Jefferson UniversityJoon-Tae Kim - Chonnam National UniversityStacey C Quintero - Wake Forest Universityansaar rai - West Virginia UniversityRobert Starke - University of Miami Health SystemMarios Psychogios - University Hospital of BaselEdgar A Samaniego - University of IowaAdam S Arthur - Semmes Murphey FoundationShinichi Yoshimura - Hyogo Medical UniversityHugo Cuellar - Louisiana State University Health Sciences Center ShreveportAli Alawieh - Emory UniversityJonathan A Grossberg - Emory UniversityDaniele G. Romano - Ospedali Riuniti San Giovanni di Dio e Ruggi d'AragonaOmar Tanweer - Baylor College of MedicineJustin Mascitelli - The University of Texas Health Science Center at San AntonioIsabel Fragata - Centro Hospitalar de Lisboa CentralAdam Polifka - University of FloridaJoshua Osbun - Washington University in St. LouisRoberto Crosa - Administracion de los Servicios de Salud del EstadoCharles C Matouk - Yale UniversityMin S Park - University of VirginiaMichael Levitt - Seattle UniversityWaleed Brinjikji - Mayo Clinic in ArizonaMark Moss - Washington Regional Medical CenterTravis Dumont - University of ArizonaRichard Williamson - Allegheny Health NetworkPedro Navia - Hospital Universitario La PazPeter Kan - The University of Texas Medical Branch at GalvestonReade A De Leacy - Mount Saint Vincent UniversityShakeel A Chowdhry - NorthShore University HealthSystemMohamad Ezzeldin - Lone Star College KingwoodAlejandro M Spiotta - Medical University of South Carolina
- Resource Type
- Abstract
- Publication Details
- Stroke (1970), Vol.55(Suppl_1)
- DOI
- 10.1161/str.55.suppl_1.TP193
- ISSN
- 0039-2499
- eISSN
- 1524-4628
- Language
- English
- Date published
- 02/2024
- Academic Unit
- Neurosurgery; Radiology; Neurology; Iowa Neuroscience Institute
- Record Identifier
- 9984557838602771
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