Abstract TP197: Impact of First-Pass Effect on Clinical Outcomes in Stroke Patients With Low Aspects

Sameh S Elawady; Mohammad Mahdi Sowlat; Hidetoshi Matsukawa; Conor Cunningham; Atakan Orscelik; Sara Zandpazandi; Sami Al Kasab; Ilko Maier; Pascal M Jabbour; Joon-Tae Kim; Stacey Q Wolfe; Ansaar Rai; Robert Starke; Edgar A Samaniego; Adam S Arthur; Shinichi Yoshimura; Hugo Cuellar; Jonathan A Grossberg; Ali Alawieh; Daniele G. Romano; Omar Tanweer; Justin mascitelli; Isabel Fragata; Adam Polifka; Joshua Osbun; Roberto Crosa; Charles C Matouk; Min S Park; Michael Levitt; Waleed Brinjikji; Mark Moss; Travis Dumont; Richard Williamson; Pedro Navia; Peter Kan; Reade A De Leacy; Shakeel A Chowdhry; Mohamad Ezzeldin; Alejandro M Spiotta

doi:10.1161/str.55.suppl_1.TP197

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Abstract TP197: Impact of First-Pass Effect on Clinical Outcomes in Stroke Patients With Low Aspects

Sameh S Elawady, Mohammad Mahdi Sowlat, Hidetoshi Matsukawa, Conor Cunningham, Atakan Orscelik, Sara Zandpazandi, Sami Al Kasab, Ilko Maier, Pascal M Jabbour, Joon-Tae Kim, …

Stroke (1970), Vol.55(Suppl_1)

02/2024

DOI: 10.1161/str.55.suppl_1.TP197

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Abstract

Abstract only Introduction: The first-pass effect (FPE), defined as a complete or near-complete recanalization after a single pass of a mechanical thrombectomy (MT) device, has been linked to favorable clinical outcomes. However, its effectiveness in acute ischemic stroke (AIS) patients with low ASPECTS (Alberta Stroke Program Early CT Score 2-5) has not been validated. Method: We utilized data from STAR, a multicenter database of 84 centers worldwide, to conduct a retrospective, cohort study on patients who underwent MT for internal carotid artery (ICA) or M1 occlusion presenting with ASPECTS 2-5. We compared the outcomes of patients who achieved FPE (successful recanalization with an mTICI score of 2c or higher in one pass) to those who did not. The primary outcome was a 90-day favorable outcome, defined as mRS 0-3. Secondary outcomes included any intracranial hemorrhage (ICH), symptomatic ICH (sICH), and 90-day mortality. Results: Out of 10,229 patients in the STAR database, 250 patients met our inclusion criteria. Among those, 60 (24%) achieved FPE. There were no significant differences between the two groups in baseline, imaging, and procedural characteristics. FPE was significantly associated with higher odds of 90-day mRS 0-3 (adjusted odds ratio (aOR): 2.17, 95% confidence interval (CI): 1.04 - 4.20; P-value: 0.04) and lower rates of ICH (OR: 0.49, 95% CI: 0.25 - 0.93, P-value: 0.03). However, there was no significant difference in sICH rates (OR: 0.84, 95% CI: 0.31 - 2.04, P-value: 0.70). Conclusion: Achieving FPE in AIS stroke patients with low ASPECTS was associated with significantly higher rates of good functional outcomes and lower rates of ICH.

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Title: Subtitle: Abstract TP197: Impact of First-Pass Effect on Clinical Outcomes in Stroke Patients With Low Aspects
Creators: Sameh S Elawady - University of Charleston
Mohammad Mahdi Sowlat - Medical University of South Carolina
Hidetoshi Matsukawa - University of Charleston
Conor Cunningham - University of Charleston
Atakan Orscelik - University of Charleston
Sara Zandpazandi - University of Charleston
Sami Al Kasab - University of Charleston
Ilko Maier - Nephrologisches Zentrum Goettingen
Pascal M Jabbour - Thomas Jefferson University
Joon-Tae Kim - Chonnam National University
Stacey Q Wolfe - Wake Forest University
Ansaar Rai - West Virginia University
Robert Starke - University of Miami Health System
Edgar A Samaniego - University of Iowa
Adam S Arthur - Semmes Murphey Foundation
Shinichi Yoshimura - Hyogo Medical University
Hugo Cuellar - Louisiana State University Health Sciences Center Shreveport
Jonathan A Grossberg - Emory University
Ali Alawieh - Emory University
Daniele G. Romano - Ospedali Riuniti San Giovanni di Dio e Ruggi d'Aragona
Omar Tanweer - Baylor College of Medicine
Justin mascitelli - The University of Texas Health Science Center at San Antonio
Isabel Fragata - Unidade Local de Saúde de São José
Adam Polifka - University of Florida
Joshua Osbun - Washington University in St. Louis
Roberto Crosa - Médica Uruguaya, Endovascular Neurosurgery, Montevideo, Uruguay
Charles C Matouk - Yale University
Min S Park - University of Virginia
Michael Levitt - Seattle University
Waleed Brinjikji - Mayo Clinic in Arizona
Mark Moss - Washington Regional Medical Center
Travis Dumont - University of Arizona
Richard Williamson - Allegheny General Hospital
Pedro Navia - Hospital Universitario La Paz
Peter Kan - The University of Texas Medical Branch at Galveston
Reade A De Leacy - Mount Saint Vincent University
Shakeel A Chowdhry - NorthShore University HealthSystem
Mohamad Ezzeldin - Lone Star College Kingwood
Alejandro M Spiotta - University of Charleston
Resource Type: Abstract
Publication Details: Stroke (1970), Vol.55(Suppl_1)
DOI: 10.1161/str.55.suppl_1.TP197
ISSN: 0039-2499
eISSN: 1524-4628
Language: English
Date published: 02/2024
Academic Unit: Neurology; Radiology; Iowa Neuroscience Institute; Neurosurgery
Record Identifier: 9984557948002771

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