Abstract Details

Title Predictors of good outcome in Acute stroke due to basilar artery occlusion from the PC-SEARCH Registry

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) S24 - Cerebrovascular Disease and Interventional Neurology: Endovascular Thrombectomy and Large Vessel Occlusions (1:48 PM-2:00 PM)

Poster/Presentation
Number 005

Objective Evaluate the effect of race/gender and to identify predictors of good outcome in a cohort of patients with BAO treated with thrombectomy.

Background Acute Basilar Artery Occlusion (BAO) results in high rate of morbidity and mortality. Recent randomized controlled trials from China demonstrated clinical benefit of mechanical thrombectomy. Further studies are needed to understand the generalizability of the findings of these trials.

Design/Methods PC-SEARCH is a large multi-center retrospective registry of consecutive acute BAOs treated with thrombectomy at eight high-volume centers across the United States from July 2015 – December 2021. Patients were included in this registry if they received mechanical thrombectomy or intra-arterial thrombolysis within 24 hours of last seen normal. Registry includes data from baseline characteristics, pre- and intra- procedural data, radiographic and clinical outcomes. Good clinical outcomes were defined as mRS ≤ 3. Multivariate logical regression models were used to evaluate race and gender disparities and to identify significant predictors of good clinical outcomes.

Results PC-SEARCH captured 519 patients, 444 with completed 90-day mRS. The mean age was 65 Y, (SD 15), NIHSS mean was 17 (IQR 8-26), and PC-ASPECTS median was 10 ( IQR 8-10). Ethnicity was Caucasian (81%), Black (16%) and Asian (1.6%). Thirty nine percent of patients were females. Good recanalization (≥TICI 2b) was achieved in 82% of patients (N = 425). Forty-five percent of patients reached mRS ≤3 with overall mortality rate of 41.4% at 90 days. Fifty-four percent of patients treated within 6 hours. In multivariate analysis, TICI score (OR 4.58, CI 2.01 – 10.05; p = 0.00) and PC-ASPECTS (OR 2.05, CI 1.21 – 3.46; p = 0.01) were the only predictors of good outcome.

Conclusions Good recanalization and pre-procedural PC-ASPECT score are significant predictors of good outcomes for acute basilar artery occlusion who underwent thrombectomy in this registry. Race and gender did not predict outcomes.

Authors/Disclosures
Adam T. Mierzwa, MD (Promedica) PRESENTER	Dr. Mierzwa has nothing to disclose.
Syed F. Zaidi, MD (ProMedica Stroke Network)	Dr. Zaidi has nothing to disclose.
Nameer Aladamat, MBBS (The University of Toledo)	Dr. Aladamat has nothing to disclose.
Khaled Gharaibeh, MD (ProMedica Neurosciences Center)	Dr. Gharaibeh has nothing to disclose.
Ehad Afreen, MD (Promedica Physicians Group Neurology)	Dr. Afreen has nothing to disclose.
Sami Alkasab, MD (MUSC)	Dr. Alkasab has nothing to disclose.
Ashley Nelson, DO (University of Rochester Medical Center/Strong Memorial Hospital)	Dr. Nelson has nothing to disclose.
Santiago Ortega Gutierrez, MD (University of Iowa)	Dr. Ortega Gutierrez has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for stryker. Dr. Ortega Gutierrez has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for medtronic. Dr. Ortega Gutierrez has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Medtronic. The institution of Dr. Ortega Gutierrez has received research support from stryker. The institution of Dr. Ortega Gutierrez has received research support from Medtronic. The institution of Dr. Ortega Gutierrez has received research support from Methinks. The institution of Dr. Ortega Gutierrez has received research support from NIH. The institution of Dr. Ortega Gutierrez has received research support from PCORI.
Juan A. Vivanco-Suarez, MD	Mr. Vivanco-Suarez has nothing to disclose.
Mudassir Farooqui, MD	Dr. Farooqui has nothing to disclose.
Ashutosh P. Jadhav, MD, FAAN (Barrow Neurological Institute)	Dr. Jadhav has nothing to disclose.
Shashvat Desai, MD (University of Pittsburgh Medical Center)	Dr. Desai has nothing to disclose.
Gabor Toth, MD (Cleveland Clinic Foundation)	Dr. Toth has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Dynamed. Dr. Toth has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Medtronic. Dr. Toth has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Kaneka. Dr. Toth has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Penumbra.
Anas M. Alrohimi, MD (University of Alberta)	Dr. Alrohimi has nothing to disclose.
Thanh Nguyen, MD	Dr. Nguyen has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Vesalio. Dr. Nguyen has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for NIH. Dr. Nguyen has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Avania. Dr. Nguyen has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for AHA. The institution of Dr. Nguyen has received research support from Boston Medical Center. The institution of Dr. Nguyen has received research support from Society of Vascular and Interventional Neurology.
Piers Klein	Mr. Klein has nothing to disclose.
Mohamad Abdalkader (Boston Medical Center Deptartment Of Radiology)	Mohamad Abdalkader has nothing to disclose.
Hisham Salahuddin, MD	Dr. Salahuddin has nothing to disclose.
	No disclosure on file
	No disclosure on file
Nirav Vora, MD	No disclosure on file
Mouhammad A. Jumaa, MD (ProMedica Stroke Network)	Dr. Jumaa has nothing to disclose.

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