Abstract Details

Title Predictors of Poor Outcome after Mechanical Thrombectomy with Successful Recanalization

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P1 - Poster Session 1 (5:30 PM-6:30 PM)

Poster/Presentation
Number 3-033

Objective To study the predictors of poor outcome in patients undergoing mechanical thrombectomy for acute stroke.

Background Despite high recanalization rate with modern thrombectomy devices, functional independence only achieved in around 50% of patients. In this study, we aimed to investigate the predictors of poor outcome in patients who underwent mechanical thrombectomy with successful recanalization.

Design/Methods A multicenter international database from 9 thrombectomy center was prospectively collected. Patients were included if they presented with anterior circulation large vessel occlusion (LVO) and underwent mechanical thrombectomy (MT) with successful recanalization. Additional criteria were Alberta Stroke Program Early CT scan (ASPECT) score 6, baseline modified Rankin Scale (mRS) 0-2. The primary outcome was 90-day mRS 3-6. Multivariate logistic regression was used to identify predictors of poor outcome.

Results A total of 1077 patients included in the study, 528 (49%) had poor outcome (mRS 3-6) at 90 days. When compared to the good outcome, the poor outcome group were older (age mean ±SD, 71 ±14 vs. 65±14 years; p<0.001), had higher NIHSS on admission (mean±SD; 18±6 vs. 14±6; p=0.001), and lower ASPECT score (median (IQR);8 (3) vs. 9(2); p <0.001). With respect to procedural variables, modified Tissue in Cerebral Infarction score (mTICI) 2c/3 was less common in poor outcome group (59% vs. 67%; p= 0.006). Antihypertensive medications were used more frequently in poor outcome group (60% vs. 49%, p =0.001). Symptomatic intracerebral hemorrhage (sICH) was more frequent in poor outcome group (8% vs. 0.6%; p<0.0001). In addition, acute kidney injury was more common in poor outcome group (13% vs. 7% p <0.001). On multivariate analysis, age, admission NIHSS, ASPECT score, sICH, AKI, antihypertensive use, and final mTICI score emerged as predictors of poor outcome.

Conclusions Older age, higher admission NIHSS, lower ASPECT score, symptomatic intracerebral hemorrhage, antihypertensive use and mTICI 2b were associated with poor outcome after successful recanalization.

Authors/Disclosures
Mohammad Anadani, MD (Medical University of South Carolina) PRESENTER	Dr. Anadani has nothing to disclose.
Mohamad Orabi, MD (Medical University of South Carolina)	No disclosure on file
	No disclosure on file
Nitin Goyal, MD (University of Tennessee HSC)	No disclosure on file
Fnu Abhi Pandhi, MD (UTHSC Dept of Neurology)	No disclosure on file
Hunter L. Mitchell, MD (University of Tennessee)	Dr. Mitchell has nothing to disclose.
Andrei V. Alexandrov, MD (Department of Neurology, UTHSC)	The institution of Dr. Alexandrov has received personal compensation in the range of $500-$4,999 for serving as a Consultant for NovaSignal. Dr. Alexandrov has received personal compensation in the range of $500-$4,999 for serving as a Consultant for NovoNordisc. Dr. Alexandrov has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for AstraZeneca. Dr. Alexandrov has received personal compensation in the range of $0-$499 for serving as an officer or member of the Board of Directors for American Society of Neuroimaging. Dr. Alexandrov has received publishing royalties from a publication relating to health care.
	No disclosure on file
	No disclosure on file
Ovais Inamullah, MD (Duke University Hospital)	Dr. Inamullah has nothing to disclose.
Shareena A. Rahman, MD (Duke Neurology)	Dr. Rahman has nothing to disclose.
Christa B. Swisher, MD (Duke University Medical Center)	Dr. Swisher has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for UCB.
Salah G. Keyrouz, MD (WUSM)	No disclosure on file
James A. Giles, MD (Yale School of Medicine)	Dr. Giles has received personal compensation for serving as an employee of Yale University. The institution of Dr. Giles has received research support from NIH/NINDS.
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
Fabio Nascimento, MD (Washington University Medical School)	Dr. Nascimento has received publishing royalties from a publication relating to health care.
	No disclosure on file
	No disclosure on file
	No disclosure on file

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