Abstract Details

Title A Case Series of Seven Patients with Recurrent Large-Vessel Strokes within 72 Hours of the Initial Event.

Topic Cerebrovascular Disease and Interventional Neurology

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

Poster/Presentation
Number 3-050

Objective We present a case series of seven patients with an average age of 65 and highly variable past medical histories who were admitted to our university hospital with a stroke secondary to a large-vessel occlusion and underwent an emergent mechanical thrombectomy. Each of these patients suffered a subsequent stroke secondary to a large-vessel occlusion and underwent an additional emergent endovascular procedure for clot retrieval.

Background Repeat thrombectomies within the same admission constitute 1.5% of all thrombectomy patients within our institution. Nationwide, such cases constitute a significant portion of all large-vessel strokes that undergo endovascular intervention. In this report, we review the hospital courses of seven patients who comprise this subgroup and discuss the significant findings related to these individuals’ recurrent large-vessel strokes within 72 hours of their initial event.

Design/Methods NA

Results Upon chart review of all seven cases, it was noted that, approximately 2 hours prior to their second event, their mean arterial pressure (MAP) dropped an average of 16 mmHg from the recorded average. These patients were not given any vaso-acting agents prior to the spontaneous drop in the MAPs.

Conclusions 84% of all patients with acute ischemic strokes present to hospital emergency departments with hypertension. The trends in these patients’ blood pressures directly prior to their event, however, remain totally unknown. Within the setting of our unique patient population, we are able to observe a peculiar, non-iatrogenic phenomenon of acute drop in MAPs immediately preceding their acute vascular event. This may present a novel marker in identifying high-risk patients for a recurrent event following an initial thrombectomy, and could provide deeper insight into the very pathophysiology preceding acute ischemic events. We will further discuss both of these possibilities within our presentation.

Authors/Disclosures
Kamil Stefanowski, MD (Department of Neurology) PRESENTER	No disclosure on file
Usman Shehzad, MD	No disclosure on file
Elzbieta J. Wirkowski, MD	No disclosure on file
	No disclosure on file

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