E-063 Number of passes in mechanical thrombectomy matters in patients with large vessel occlusion presenting with low aspects score

M Sowlat; Sameh S Elawady; H Matsukawa; J Isidor; C Cunningham; R Abo Kasem; A Orscelik; I Maier; P Jabbour; J Kim; S Quintero Wolfe; A Rai; R M Starke; M Psychogios; E A Samaniego; N Goyal; S Yoshimura; H Cuellar; J A Grossberg; A Alawieh; A Alaraj; M Ezzeldin; D G Romano; O Tanweer; J Mascitelli; I Fragata; A Polifka; F Siddiqui; J Osbun; R Grandhi; R Crosa; C Matouk; M S Park; M R Levitt; W Brinjikji; M Moss; E Daglioglu; R Williamson; P Navia; P Kan; R De Leacy; S Chowdhry; D J Altschul; A M Spiotta

doi:10.1136/jnis-2024-SNIS.168

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E-063 Number of passes in mechanical thrombectomy matters in patients with large vessel occlusion presenting with low aspects score

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E-063 Number of passes in mechanical thrombectomy matters in patients with large vessel occlusion presenting with low aspects score

M Sowlat, Sameh S Elawady, H Matsukawa, J Isidor, C Cunningham, R Abo Kasem, A Orscelik, I Maier, P Jabbour, J Kim, …

Journal of neurointerventional surgery, Vol.16(Suppl 1), pp.A119-A120

07/21/2024

DOI: 10.1136/jnis-2024-SNIS.168

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Abstract

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.MethodsThis 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, 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 (11.8%) patients with 3 passes (11.8%), 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 the number of MT passes but the odds of achieving favorable outcome declined with each pass.

SNIS 21st annual meeting electronic poster abstracts

Details

Title: Subtitle: E-063 Number of passes in mechanical thrombectomy matters in patients with large vessel occlusion presenting with low aspects score
Creators: M Sowlat - Medical University of South Carolina
Sameh S Elawady - Medical University of South Carolina
H Matsukawa - Medical University of South Carolina
J Isidor - Medical University of South Carolina
C Cunningham - Medical University of South Carolina
R Abo Kasem - Medical University of South Carolina
A Orscelik - Medical University of South Carolina
I Maier - Universitätsmedizin Göttingen
P Jabbour - Thomas Jefferson University
J Kim - Chonnam National University Hospital
S Quintero Wolfe - Central Baptist Hospital
A Rai - West Virginia University
R M Starke - University of Miami Health System
M Psychogios - University Hospital of Basel
E A Samaniego - University of Iowa
N Goyal - University of Tennessee at Knoxville
S Yoshimura - Hyogo Medical University
H Cuellar - Louisiana State University Health Sciences Center Shreveport
J A Grossberg - Emory University
A Alawieh - Emory University
A Alaraj - University of Chicago
M Ezzeldin - University of Houston
D G Romano - Ospedali Riuniti San Giovanni di Dio e Ruggi d'Aragona
O Tanweer - Baylor College of Medicine
J Mascitelli - The University of Texas Health Science Center at San Antonio
I Fragata - Universidade Nova de Lisboa
A Polifka - University of Florida
F Siddiqui - Neurosurgery, University of Michigan Health West, Wyoming, MI
J Osbun - Washington University in St. Louis
R Grandhi - University of Utah
R Crosa - Universidad de Montevideo
C Matouk - University of New Haven
M S Park - University of Virginia
M R Levitt - University of Washington
W Brinjikji - Mayo Clinic
M Moss - Washington Regional Medical Center
E Daglioglu - Ankara Bilkent City Hospital
R Williamson - Allegheny General Hospital
P Navia - Hospital Universitario La Paz
P Kan - The University of Texas Medical Branch at Galveston
R De Leacy - Mount Sinai Health System
S Chowdhry - NorthShore University HealthSystem
D J Altschul - Albert Einstein College of Medicine
A M Spiotta - Medical University of South Carolina
Resource Type: Abstract
Publication Details: Journal of neurointerventional surgery, Vol.16(Suppl 1), pp.A119-A120
DOI: 10.1136/jnis-2024-SNIS.168
ISSN: 1759-8478
eISSN: 1759-8486
Publisher: BMJ Publishing Group Ltd
Language: English
Date published: 07/21/2024
Academic Unit: Neurology; Radiology; Iowa Neuroscience Institute; Neurosurgery
Record Identifier: 9984688445702771

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