Abstract Details

Title White matter disease and recovery following endovascular thrombectomy after acute ischemic stroke

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P11 - Poster Session 11 (11:45 AM-12:45 PM)

Poster/Presentation
Number 6-006

Objective To determine the impact of chronic white matter lesions (WML) on functional outcomes in patients with acute stroke who underwent endovascular thrombectomy (EVT).

Background The evidence regarding the impact of chronic WML on functional outcomes after EVT is mixed.

Design/Methods A prospective stroke center registry (10/2019-06/2021) of consecutive adult patients with acute stroke was queried for patients with ICA or M1 occlusions who had undergone magnetic resonance imaging (MRI). Multivariable logistic regression was used to estimate the relationship between age, Alberta Stroke Program Early Computed Tomography Scale score, National Institutes of Health Stroke Scale, occlusion location, and successful recanalization (thrombolysis in cerebral infarction score of 2b-3 versus 0-2a or no thrombectomy) on good functional outcome (90-day mRS 0-2). Mediation analysis was used to estimate the effect of WML severity on age as a predictor of good functional outcome following successful recanalization.

Results Among the 121 included patients, the median age was 67y (IQR 58-77), 49 (40.5%) were female, and 39 (32.2%) had a Fazekas score of 2 or 3. In unadjusted regression, age was associated with WML severity (step 1: OR 1.03, 95% CI 1.02-1.04, p<0.001), and age was associated with an unfavorable 90-day mRS (step 2: proportional OR 0.98, 95% CI 0.95-0.99, p = 0.027). WML severity was also associated with 90-day mRS (step 3: OR 0.74, 95% CI 0.52-1.06, p=0.096). In multivariable regression, the total effect of age on unfavorable shift in 90-day mRS remained significant (OR 0.96, 95% CI 0.94-0.98, p<0.001), with a trend toward a persistent indirect mediator effect of WML (p=0.084). The mediator WML severity explained 23% of the association of age with 90-day mRS.

Conclusions In this single center analysis, WML burden partially mediated the effect of age on functional recovery in acute stroke.

Authors/Disclosures
Nicholas Vigilante III PRESENTER	Mr. Vigilante has nothing to disclose.
	No disclosure on file
Mary Penckofer, MD	Ms. Penckofer has nothing to disclose.
	No disclosure on file
Pratit D. Patel, MD (Capital Health)	Dr. Patel has nothing to disclose.
Jane Khalife, MD (Thomas Jefferson University Hospital)	Dr. Khalife has nothing to disclose.
Renato Oliveira, MD (University of Alabama at Birmingham)	Dr. Oliveira has nothing to disclose.
	No disclosure on file
Jesse Thon, MD (Cooper University Hospital)	An immediate family member of Dr. Thon has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Horizon. An immediate family member of Dr. Thon has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genentech. An immediate family member of Dr. Thon has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Genentech.
James E. Siegler III, MD (University of Chicago)	Dr. Siegler has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Siegler has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Bayer. Dr. Siegler has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Serb. Dr. Siegler has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Ceribell. Dr. Siegler has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Wallaby Phenox. Dr. Siegler has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Stroke: Vascular and Interventional Neurology. Dr. Siegler has received personal compensation in the range of $50,000-$99,999 for serving as an Expert Witness for Precision Medicine, LLC. The institution of Dr. Siegler has received research support from Philips. The institution of Dr. Siegler has received research support from Medtronic.

��ɫ��

��ɫ��