Abstract Details

Title Utility of Intravenous Alteplase and Mechanical Thrombectomy in Central Retinal Arterial Occlusions – A Nationwide Analysis

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P7 - Poster Session 7 (11:45 AM-12:45 PM)

Poster/Presentation
Number 5-022

Objective

We aim to better understand the effectiveness of revascularization therapies in central retinal artery occlusion (CRAO) patients compared to acute ischemic stroke (AIS) patients.

Background

CRAO is a rare and visually debilitating vascular condition characterized by sudden and severe vision loss. Sharing pathological similarities with AIS, this condition is a compelling target for treatments such as intravenous alteplase (tPA) and endovascular mechanical thrombectomy (MT). However, there is a limited understanding of the utility of these interventions in CRAO.

Design/Methods

To assess the usage and outcomes of tPA and MT in CRAO, we queried the National Inpatient Sample (NIS) database using International Classification of Disease Ninth and Tenth editions.

Results

Between 2010 and 2019, the NIS database recorded 1,609,817 cases of AIS and 5009 cases of CRAO. Compared to AIS patients, CRAO patients were younger and had higher rates of obesity, hypertension, long-term anticoagulant use, and tobacco use. Our analysis revealed lower rates of tPA administration (3.41% vs. 6.21%) and endovascular MT (0.38% vs. 1.31%) in the CRAO group. Moreover, CRAO patients experienced fewer complications, including deep vein thrombosis, pneumonia, urinary tract infection, acute kidney injury, and acute myocardial infarction (all p < 0.01). Regarding clinical outcomes, CRAO patients exhibited lower rates of poor functional outcome (31.74% vs. 58.1%) and in-hospital mortality (1.2% vs. 5.64%), but higher occurrences of profound blindness (9.24% vs. 0.58%). A multivariate regression found no relationship between tPA and MT and profound blindness.

Conclusions

CRAO is a rare vascular condition with fewer complications compared to AIS. The limited sample size of patients receiving interventions may have contributed to their apparent insignificance in protecting against profound blindness in the multivariate analysis. Future studies investigating larger patient cohorts and exploring alternative treatment modalities will be valuable to provide insights for optimizing visual restoration and enhancing outcomes in CRAO cases.

Authors/Disclosures
Patricia Xu PRESENTER	Miss Xu has nothing to disclose.
Galadu Subah	No disclosure on file
Bridget Nolan	No disclosure on file
Aiden Lui	No disclosure on file
Eric Feldstein	Eric Feldstein has nothing to disclose.
Alan Stein	No disclosure on file
Chirag Gandhi (Westchester Medical Center)	Chirag Gandhi has nothing to disclose.
Fawaz Al-Mufti, MD (Westchester Medical Center at New York Medical College)	Dr. Al-Mufti has received personal compensation in the range of $0-$499 for serving as a Consultant for Stryker. Dr. Al-Mufti has received personal compensation in the range of $0-$499 for serving as a Consultant for Cerenovus. Dr. Al-Mufti has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Revalesio .

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