Abstract Details

Title Aortic Arch Calcification and Outcomes of Endovascular Treatment of Acute Ischemic Stroke

Topic Interventional Neurology

Presentation(s) P07 - (-)

Poster/Presentation
Number 266

Objective

Background BACKGROUND: Aortic arch calcification is frequently seen in patients with cardiovascular diseases as a marker of aortic atherosclerosis. Severe aortic disease can add considerable complexity to accessing supra-aortic arteries as part of endovascular treatment of acute ischemic stroke.

Design/Methods DESIGN/METHODS: All acute ischemic stroke patients who underwent a computed tomographic (CT) angiogram and subsequently underwent endovascular treatment were included. The thoracic component of CT angiogram images were reviewed by an independent reviewer to determine presence of any calcification and severity of calcification was graded as follows: mild, single small calcifications; moderate, multiple small calcifications; severe, one or more large calcifications. The difference between small and large calcification was based on whether the calcification was larger than the radius of the aortic arch.

Results RESULTS: Aortic arch evaluation was performed in 188 patients (mean age±SD of 65±16 years). Aortic arch calcification was present in 120(62.4%) of 188 patients and severity was graded as mild (n=24), moderate (n=44), and severe (n=52). Compared with patients without calcification, the mean time interval between initiation of angiography to microcatheter placement (minutes ± SD) was similar among patients with aortic arch calcification (70±31 versus 64±31, p=0.9). The mean time interval increased with increasing severity of aortic arch calcification (61±27, 67±29, and 74±34, p=0.3). Patients with aortic arch calcification had similar rates of complete or partial recanalization [85(71%) versus 50(76%)], p=0.6) but lower rates of favorable outcomes [modified Rankin scale 0-2] at discharge 27(22.5%) versus 26(38.8%), p= 0.02). (Unfavorable outcome 93(77.5%) versus 41(61.2%).

Conclusions CONCLUSIONS: A high proportion of acute ischemic stroke patients have aortic arch calcification which is associated with greater complexity of endovascular treatments and worse clinical outcomes.

Authors/Disclosures
PRESENTER	No disclosure on file
Martin Rakusa, MD (University Medical Centre Maribor)	No disclosure on file
	No disclosure on file
	No disclosure on file
Hamza I. Maqsood, MD (Dept of Neurology)	Dr. Qureshi has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for AstraZeneca.
Andrew Lee	No disclosure on file

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