Abstract Details

Title National Trends in Utilization and Outcomes of Emergent Carotid Artery Stent Placement in Acute Ischemic Stroke Patients

Topic Interventional Neurology

Presentation(s) P07 - (-)

Poster/Presentation
Number 268

Objective

Background BACKGROUND: Subsequent to recent trials of CAS placement, emergent stent placement in acute ischemic stroke is being considered more frequently as part of the endovascular treatment.

Design/Methods DESIGN/METHODS: We obtained data for patients admitted to hospitals in the United States between 2004 to 2009 with a primary diagnosis of ischemic stroke using the Nationwide inpatient sample, a nationally representative data of acute care hospitalizations. We determined the rate of utilization of emergent CAS as part of endovascular treatment and outcomes according to use of emergent CAS or not. Outcomes were classified as minimal disability, moderate to severe disability, and death based on discharge disposition.

Results RESULTS: Of the 12,720 patients who underwent endovascular treatment, 1000 patients had emergent CAS (mean age [±SD] 65±12.8 years). The estimated number of patients undergoing emergent CAS increased by 7 fold (46 in 2004 to 336 in 2009). The rates of intracranial hemorrhage remained unchanged throughout the 6 years. The rates of none to minimal disability were significantly higher (odds ratio [OR] 2.0, 95% confidence interval [CI] 1.3-3.1, p value=0.001) and in-hospital mortality was significantly lower [OR 0.6, 95% CI 0.4-0.9, p value=0.009] among patients who underwent endovascular treatment with emergent CAS after adjusting for potential confounders.

Conclusions CONCLUSIONS: There has been a significant increase in the proportion of acute ischemic stroke patients receiving emergent CAS with high rates of favorable outcomes and low rates of in-hospital mortality.

Authors/Disclosures
Ameer Hassan, DO (Valley Baptist Medical Center) PRESENTER	Dr. Hassan has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Medtronic. Dr. Hassan has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Stryker. Dr. Hassan has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Penumbra. Dr. Hassan has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Cerenovus. Dr. Hassan has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Viz.ai. Dr. Hassan has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Genentech. Dr. Hassan has received research support from GE Healthcare.
	No disclosure on file
Haralabos Zacharatos, MD	Dr. Zacharatos has nothing to disclose.
Mikayel Grigoryan, MD (Axon Neurology)	Dr. Grigoryan has nothing to disclose.
	No disclosure on file
Saqib A. Chaudhry, MD	Dr. Chaudhry has nothing to disclose.
Wondwossen G. Tekle, MD	Dr. Tekle has nothing to disclose.
Rakesh Khatri, MD, FAAN	Dr. Khatri has received personal compensation in the range of $0-$499 for serving as a Survey consultant with Alpha insight . Dr. Khatri has received personal compensation in the range of $0-$499 for serving as a Survey consultant with Survey company .
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.
	No disclosure on file

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