O-069 Effect of intravenous thrombolysis before endovascular therapy on outcomes in patients with large core infarct: insight from the STAR registry

M Anadani; A Shaban; S Al Kasab; R Chalhoub; I Maier; M Psychogios; A Alaweih; S Wolfe; A Authur; T Dumont; P Kan; J Kim; R De Leacy; J Osbun; A Rai; P Jabbour; M Park; J Mascitelli; M Levitt; A Polifka; W Casagranda; S Yoshimura; C Matouk; R Williamson; B Gory; M Mokin; I Fragata; D Romano; S Chowdry; M Moss; D Behme; K Limaye; A Spiotta; E Samaniego

doi:10.1136/neurintsurg-2022-SNIS.69

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O-069 Effect of intravenous thrombolysis before endovascular therapy on outcomes in patients with large core infarct: insight from the STAR registry

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O-069 Effect of intravenous thrombolysis before endovascular therapy on outcomes in patients with large core infarct: insight from the STAR registry

M Anadani, A Shaban, S Al Kasab, R Chalhoub, I Maier, M Psychogios, A Alaweih, S Wolfe, A Authur, T Dumont, …

Journal of neurointerventional surgery, Vol.14(Suppl 1), pp.A45-A45

07/23/2022

DOI: 10.1136/neurintsurg-2022-SNIS.69

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Abstract

BackgroundThe utility of intravenous thrombolysis (IVT) before mechanical thrombectomy (MT) remains a matter of debate. The data regarding the safety and efficacy of IVT prior to MT in patients with large core infarct is scarce.ObjectiveTo compare the functional and safety outcomes between patients with large core infarct due to LVO treated with IVT and MT to those treated with MT alone.MethodsThis is a retrospective analysis of the Stroke Thrombectomy Aneurysm Registry (STAR). Large core infarct was defined as Albert Stroke Program Early CT Score (ASPECTS) ≤5. Patients with large core infarct due to anterior circulation large vessel occlusion (internal carotid artery occlusion, M1 segment occlusion, or tandem occlusion) treated with MT were enrolled in this study. Patients were divided into two groups based on pretreatment intravenous thrombolysis (IVT+, IVT-). The association between IVT and favorable outcome (mRS 0–2) or significant intracranial hemorrhage (PH2 or sICH) was assessed using a logistic regression model adjusted for age, sex, admission NIHSS, onset to groin time, and pre-stroke mRS.ResultsOf 6151 patients enrolled in the STAR registry during the study period, 398 patients (mean age 67.5 14 years, median NIHSS 19, median onset to groin 321 minutes) met our inclusion criteria and were included in the final analysis. Favorable outcome was achieved in 27.3%, and 17.4% in the IVT+ and IVT- groups (p=0.027), respectively. Significant ICH (sICH or PH2) occurred in 16.9% and 13.1% in the IVT+ and IVT- groups (p-0.26), respectively. In an adjusted logistic regression model, IVT was not associated with favorable outcomes (OR, 1.78; 95% CI 0.91–3.48) or significant hemorrhage (OR, 1.36; 95% CI 0.71–2.59).ConclusionPatients with large core infarct due to large vessel occlusion treated with intravenous thrombolysis and mechanical thrombectomy had comparable outcomes to those treated with mechanical thrombectomy alone.Disclosures M. Anadani: None. A. Shaban: None. S. Al Kasab: None. R. Chalhoub: None. I. Maier: None. M. Psychogios: None. A. Alaweih: None. S. Wolfe: None. A. Authur: None. T. Dumont: None. P. Kan: None. J. Kim: None. R. De Leacy: None. J. Osbun: None. A. Rai: None. P. Jabbour: None. M. Park: None. J. Mascitelli: None. M. Levitt: None. A. Polifka: None. W. Casagranda: None. S. Yoshimura: None. C. Matouk: None. R. Williamson: None. B. Gory: None. M. Mokin: None. I. Fragata: None. D. Romano: None. S. Chowdry: None. M. Moss: None. D. Behme: None. K. Limaye: None. A. Spiotta: None. E. Samaniego: None.

SNIS 19th annual meeting oral abstracts

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Title: Subtitle: O-069 Effect of intravenous thrombolysis before endovascular therapy on outcomes in patients with large core infarct: insight from the STAR registry
Creators: M Anadani - Medical University of South Carolina
A Shaban - University of Iowa
S Al Kasab - Medical University of South Carolina
R Chalhoub - Medical University of South Carolina
I Maier - Department of Neurology, University Medicine Göttingen, Göttingen, Germany
M Psychogios - Neuroradiology, University Hospital Basel, Basel, Switzerland
A Alaweih - Emory University School of Medicine
S Wolfe - Neurosurgery, Wake Forest School of Medicine, Winston-Salem, NC
A Authur - University of Tennessee Health Science Center
T Dumont - University of Arizona
P Kan - Baylor School
J Kim - Chonnam National University Hospital
R De Leacy - Mount Sinai Health System
J Osbun - Neurosurgery, Washington University of School of Medicine, St. Louis, MO
A Rai - Neurosurgery, West Virginia School of Medicine, Morgantown, WV
P Jabbour - Thomas Jefferson University
M Park - University of Virginia
J Mascitelli - Neurosurgery, University of Texas Health Science Center at San Antonio, San Antonio, TX
M Levitt - University of Washington
A Polifka - Neurosurgery, University of Florida, Gainsville, FL
W Casagranda - Cerebrovascular and Endovascular Neurosurgery, Hospital Juan Fernandez, Buenos Aires, Argentina, Argentina, Argentina
S Yoshimura - Hyogo Medical University
C Matouk - Yale School of Medicine
R Williamson - Allegheny Health Network
B Gory - Diagnostic and Therapeutic Neuroradiology, Centre Hospitalier Régional Universitaire de Nancy, Nancy, France
M Mokin - Neurosurgery, University of South Florida, Tampa, FL
I Fragata - Neuroradiology, Hospital São José Centro Hospitalar, Lisboa, Portugal
D Romano - Neuroscience, Aou S. Giovanni I Dio e Ruggi d'Aragona Hospital, Salerno SA, Italy
S Chowdry - Neurosurgery, NorthShore University Health System, Evanston, IL
M Moss - Washington Regional Medical Center
D Behme - University Hospital Magdeburg
K Limaye - Indiana University Bloomington
A Spiotta - Medical University of South Carolina
E Samaniego - University of Iowa
Resource Type: Abstract
Publication Details: Journal of neurointerventional surgery, Vol.14(Suppl 1), pp.A45-A45
DOI: 10.1136/neurintsurg-2022-SNIS.69
ISSN: 1759-8478
eISSN: 1759-8486
Publisher: BMJ Publishing Group Ltd
Language: English
Date published: 07/23/2022
Academic Unit: Neurology; Radiology; Iowa Neuroscience Institute; Neurosurgery
Record Identifier: 9984277452702771

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