Abstract Details

Title Endovascular Treatment in Acute Ischemic Stroke: A Decade-long Experience from a Single Center in Saudi Arabia

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P9 - Poster Session 9 (8:00 AM-9:00 AM)

Poster/Presentation
Number 5-027

Objective

To present the clinical, radiological features, and outcomes of patients who underwent endovascular therapy (EVT) at a tertiary care center in Saudi Arabia.

Background

Endovascular treatment (EVT) has been used in ischemic stroke care for almost 2 decades. After several positive trials in 2015, EVT became the standard of care for acute ischemic stroke with large vessel occlusion (LVO).

Design/Methods

An IRB-approved, retrospective cohort study of all patients who underwent EVT between January 2012 and December 2022.

Results A total of 159 patients underwent EVT; 97 (61%) were males. The mean age was 56.8±14.1 years. Most patients had moderate 61 (39%) to severe 70 (45%) stroke. The commonest LVO was right MCA 60 (38%), followed by left MCA 59 (37%), and basilar artery 30 (19%). The initial ASPECT score was 8.2±1.4. The median door-to-groin time was 126 (IQR 102 – 152) minutes. 133 (84%) had EVT within 6 hours, whereas 26 (16%) had between 6-24 hours. Intravenous tPA was used in 78 (49%) patients. Successful recanalization (TICI2b and above) was achieved in 125 (78%). Stent retriever 137 (87%) and aspiration 62 (40%) were the most common used techniques. Periprocedural complications were seen in 20 (13%), intraparenchymal hemorrhage was seen in 19 (12%) patients, whereas 15 (9%) patients required decompressive craniectomy. Forty-four (28%) had mRS of 0-2 at discharge, whereas 37 (23%) died. Females were older than males (53 versus 62 years; p<0.001). Cardioembolic and large vessel strokes were more common in patients >60 years (p<0.001). Females were more likely to have general anesthesia (p=0.036) and require decompressive craniectomy (p=0.003). Patients who had EVT beyond 6 hours were more likely to have very severe stroke (p=0.005) and death (p<0.001).

Conclusions EVT was associated with good procedural outcomes in our center despite slightly delayed door-to-groin time. Periprocedural complications and mortality were similar to the published literature.

Authors/Disclosures
Mohammed Alnafisah, MBBS (National Guard Hospital Health Affairs) PRESENTER	Dr. Alnafisah has nothing to disclose.
Zaid F. Alsaaran, Jr., MBBS	Dr. Alsaaran has nothing to disclose.
Ismail A. Khatri, MD, MBBS, FAAN (King Abdul Aziz Medical City, Ministry of National Guard Health Affairs)	Dr. Khatri has nothing to disclose.
Noran Taher, MD	Dr. Taher has nothing to disclose.
Nazish Masud (Georgia Southern University)	No disclosure on file
Mufadhi M. Alshammary, MBBS (King Abdulaziz Medical City-Riyadh)	Dr. Alshammary has nothing to disclose.
Mohammad Ejaz Ahmed	No disclosure on file

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