Abstract TP198: Factors Associated With Need for Decompressive Hemicraniectomy After Mechanical Thrombectomy in Stroke Patients

Sameh Samir Elawady; Conor Cunningham; Hidetoshi Matsukawa; Kazutaka Uchida; Mohammad-Mahdi Sowlat; Noah Lee Nawabi; Sara Zandpazandi; Atakan Orscelik; Ilko Maier; Pascal M Jabbour; Joon-Tae Kim; Stacey C Quintero; ansaar rai; Robert Starke; Marios Psychogios; Amir Shaban; Adam S Arthur; Shinichi Yoshimura; Hugo Cuellar; Ali M Alawieh; Brian Howard; 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.TP198

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Abstract TP198: Factors Associated With Need for Decompressive Hemicraniectomy After Mechanical Thrombectomy in Stroke Patients

Sameh Samir Elawady, Conor Cunningham, Hidetoshi Matsukawa, Kazutaka Uchida, Mohammad-Mahdi Sowlat, Noah Lee Nawabi, Sara Zandpazandi, Atakan Orscelik, Ilko Maier, Pascal M Jabbour, …

Stroke (1970), Vol.55(Suppl_1)

02/2024

DOI: 10.1161/str.55.suppl_1.TP198

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Abstract

Abstract only Background: Mechanical thrombectomy (MT) has significantly reduced morbidity and mortality in acute ischemic stroke (AIS). This study aims to analyze the outcomes and factors associated with decompressive hemicraniectomy (DHC) in AIS patients who underwent MT. Methods: We retrospectively analyzed data from an ongoing, multicenter database to investigate AIS patients who underwent MT for ICA, M1, or M2 occlusion. We compared clinical and procedural variables between patients who underwent DHC and those who did not. Propensity score (PS) matching between the two groups was conducted using age, sex, admission NIHSS, occluded vessel, ASPECTS, time from symptoms onset to arterial puncture, intracranial hemorrhage (ICH), and symptomatic ICH (sICH). Results: Among the 3,135 MT patients who met our inclusion criteria, 113 underwent DHC. A 1:3 propensity matching yielded a well-matched cohort of 113 in the DHC group versus 339 in the non-DHC group. The DHC group had a significantly higher rate of successful recanalization (mTICI ≥ 2C) (175 [51.6%] versus 36 [31.9%], P < 0.001) and a longer procedure duration, with a median of 30 minutes (IQR: 17-54) compared to 44 minutes (IQR: 25-78) in the non-DHC group (P = <0.001). Further comparison of patients with low ASPECTS (≤ 5) who underwent DHC (n = 36) with those who did not (n = 99) showed no significant difference in successful recanalization rates (15 [41.7%] versus 43 [43.4%], P > 0.90). However, procedure duration was significantly longer in the DHC group with a median of 29 minutes (IQR: 13-52), compared to 39 minutes (IQR: 27-86) in the non-DHC group (P = 0.02). Conclusions: Successful recanalization can help in preventing DHC in AIS patients with high ASPECTS, but not those with low ASPECTS. Procedure duration is independently related to DHC following MT, especially in low ASPECTS patients.

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Title: Subtitle: Abstract TP198: Factors Associated With Need for Decompressive Hemicraniectomy After Mechanical Thrombectomy in Stroke Patients
Creators: Sameh Samir Elawady - University of Charleston
Conor Cunningham - University of Charleston
Hidetoshi Matsukawa - University of Charleston
Kazutaka Uchida - Hyogo University
Mohammad-Mahdi Sowlat - Medical University of South Carolina
Noah Lee Nawabi - Medical University of South Carolina
Sara Zandpazandi - University of Charleston
Atakan Orscelik - University of Charleston
Ilko Maier - Nephrologisches Zentrum Goettingen
Pascal M Jabbour - Thomas Jefferson University
Joon-Tae Kim - Chonnam National University
Stacey C Quintero - Wake Forest University
ansaar rai - West Virginia University
Robert Starke - University of Miami Health System
Marios Psychogios - University Hospital of Basel
Amir Shaban - University of Iowa
Adam S Arthur - Semmes Murphey Foundation
Shinichi Yoshimura - Hyogo Medical University
Hugo Cuellar - Louisiana State University Health Sciences Center Shreveport
Ali M Alawieh - Emory University
Brian Howard - 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 - Administracion de los Servicios de Salud del Estado
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 - University of Houston
Alejandro M Spiotta - University of Charleston
Resource Type: Abstract
Publication Details: Stroke (1970), Vol.55(Suppl_1)
DOI: 10.1161/str.55.suppl_1.TP198
ISSN: 0039-2499
eISSN: 1524-4628
Language: English
Date published: 02/2024
Academic Unit: Neurology
Record Identifier: 9984557840902771

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