Abstract Details

Title Outcomes in Patients with ASPECTS of 5-7 Undergoing Endovascular Reperfusion Therapy for Acute Ischemic Stroke

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P04 - (-)

Poster/Presentation
Number 060

Objective

Background BACKGROUND: Intra-arterial (IA) therapy has been increasingly utilized to treat patients with LVO acute stroke with high NIHSS. The size of infarct core has been linked to a higher rate of intracranial hemorrhage and worse outcomes. Patients with ASPECTS>7 appear to have the best clinical outcomes. Reperfusion benefits for patients with lower ASPECTS remains to be studied.

Design/Methods DESIGN/METHODS: A retrospective review of LVO stroke patients with ASPECTS 5-7 was performed. Symptomatic hemorrhage was defined as PH2 hemorrhage based on the ECASS definition. Successful reperfusion was defined as TICI 2A or greater. Good and acceptable clinical outcome were defined as 90 day mRS of 0-2 and 0-3, respectively. Infarct volume was measured based on the CT or MRI obtained more than 24 hours after the procedure.

Results RESULTS: A total of 76 patients were identified (mean age 66±13 years, mean NIHSS 20±6.) Successful reperfusion was achieved in 43 patients (57%). Symptomatic hemorrhages occurred in 9 patients (12%) while asymptomatic hemorrhages were noted in 29 (38%) patients. Fourteen patients (18%) achieved a good clinical outcome while 23 (30%) achieved an acceptable outcome. The median final infarct volume was 90 cm3 [IQR 49-155 cm3]. Patients with successful reperfusion were more likely to achieve a good clinical outcome (26% vs. 9%, p<0.045) and acceptable clinical outcome (40% vs. 12%, p<0.03).

Conclusions CONCLUSIONS: Despite the low probability of achieving good clinical outcome in patients with ASPECTS 5-7 who underwent IA therapy, successful revascularization still results in less disability when compared to non-reperfused patients. Therefore, IA therapy may be a reasonable option in patients and families who favor a shift from severe to moderate disability. Further larger prospective studies are warranted to confirm these results.

Authors/Disclosures
Alireza Noorian, MD PRESENTER	No disclosure on file
Srikant Rangaraju, MBBS (Emory University, Atlanta)	Dr. Rangaraju has nothing to disclose.
Kumiko Owada, MD (Wellstar Medical Group)	No disclosure on file
	No disclosure on file
Tudor G. Jovin, MD (Cooper University Healthcare)	Dr. Jovin has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Cerenovus. Dr. Jovin has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Contego Medical. Dr. Jovin has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for Several law firms. Dr. Jovin has stock in Corindus. Dr. Jovin has stock in Methinks. Dr. Jovin has stock in Viz.ai. Dr. Jovin has stock in Route92. Dr. Jovin has stock in FreeOx Biotech. Dr. Jovin has stock in Galaxy. Dr. Jovin has stock in Kandu. The institution of Dr. Jovin has received research support from Stryker. The institution of Dr. Jovin has received research support from Medtronic.
	No disclosure on file
Samir Belagaje, MD, FAAN (Dept of Neurology Emory University)	Dr. Belagaje has nothing to disclose.
Aaron M. Anderson, MD (Emory University)	Dr. Anderson has nothing to disclose.
Fadi B. Nahab, MD	Dr. Nahab has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Legal Consultation. Dr. Nahab has received intellectual property interests from a discovery or technology relating to health care.
Michael R. Frankel, MD (Emory Univ School of Med/Dept of Neuro)	The institution of Dr. Frankel has received research support from Nico Corporation, Inc.
Raul G. Nogueira, MD (UPMC Stroke Institute)	Dr. Nogueira has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for for advisory roles with Anaconda, Biogen, Cerenovus, Genentech, Hybernia, Imperative Care, Medtronic, Phenox, Philips, Prolong Pharmaceuticals, Stryker Neurovascular, Shanghai Wallaby, and Synchron (consulting fees) as well as for advisory roles with Astrocyte, Brainomix, Cerebrotech, Ceretrieve, Corindus Vascular Robotics, Vesalio, Viz-AI, RapidPulse and Perfuze ( stock options). Dr. Nogueira has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for Law Firms. Dr. Nogueira has received stock or an ownership interest from Viz-AI, Perfuze, Cerebrotech, Reist/Q'Apel Medical, Truvic, and Viseon. The institution of Dr. Nogueira has received research support from Cerenovus.
Rishi Gupta, MD	No disclosure on file

��ɫ��

��ɫ��