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Abstract Details

Tissue Based Selection for Large Vessel Occlusion Thrombectomy Leads to Similar Functional Outcomes in Conventional (0-6 hours) and Extended (>6 hours) Window
Cerebrovascular Disease and Interventional Neurology
P5 - Poster Session 5 (5:30 PM-6:30 PM)
3-049
To determine if time to revascularization modifies the effect of functional outcome in stroke patients with evidence of salvageable tissue on CT perfusion (CTP).
Recent trials have shown benefit of thrombectomy in carefully selected patients in the extended (>6 hours) window. However, it is not clear if the outcomes differ from those undergoing thrombectomy in the conventional (0-6 hours) window. We sought to evaluate if time to treatment modifies the effect of endovascular reperfusion in stroke patients with evidence of salvageable tissue on CT perfusion (CTP).
We retrospectively analyzed data of consecutive patients who underwent thrombectomy in a single center cohort. Demographics, comorbidities, National Institute of Health Stroke Scale (NIHSS), vessel occlusion location, onset to skin puncture time, core infarct volume on initial CTP, recanalization (mTICI IIb/III) rates, final infarct volume and modified rankin scale (mRS) at 90 days were compared between patients who underwent thrombectomy in conventional (0-6 hours) and extended (>6 hour) window.
119 patients were studied of which 55% were female. Univariate analysis showed that the groups (Conventional vs. Extended) were balanced for age (p=0.37), NIHSS (p=0.35), vessel occlusion location (p=0.51), initial core infarct volume (p=0.64) and recanalization (mTICI IIb/III) rates (p=0.55). Final infarct volume (p=0.18) and favorable outcome (mRS 0-2) at 90 days (p=0.65) were similar. Shift analysis did not reveal any significant difference in 90 day outcome (p=0.34). (Figure) After adjustment; age (p=0.004) and final infarct volume (p<0.001) were predictive of favorable outcome.
Tissue based selection with CTP for thrombectomy in large vessel occlusion stroke is independent of onset time for favorable functional outcome.
Authors/Disclosures
Chantal Bhan, DO
PRESENTER 		Dr. Bhan has nothing to disclose.
Muhib Khan, MD, FAAN (Mayo Clinic) The institution of Dr. Khan has received research support from Mayo Clinic 好色先生 Grant . The institution of Dr. Khan has received research support from Mayo Clinic Small Grants .
Lee Elisevich No disclosure on file
Tracy J. Koehler Tracy J. Koehler has nothing to disclose.
No disclosure on file
No disclosure on file
No disclosure on file
Bassel Raad, MD (Advent Health) No disclosure on file
Joseph Zachariah, DO (Spectrum Health) Dr. Zachariah has nothing to disclose.
Jordan A. Combs, MD (Spectrum Health) Dr. Combs has nothing to disclose.
Michelle D. DeJesus Brazitis, MD (Spectrum Health) Dr. DeJesus Brazitis has nothing to disclose.
No disclosure on file
No disclosure on file
No disclosure on file
Jiangyong Min, MD (Corewell Health West) Dr. Min has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Medtronic . Dr. Min has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for CredentialMed, LLC. The institution of Dr. Min has received research support from Corerwell Health Foundation .
No disclosure on file
Tamer Abdelhak, MD (Albany Medical College) Dr. Abdelhak has nothing to disclose.