Abstract Details

Title Comparative Outcome Analysis of Endovascular Acute Ischemic Stroke Treatment in Patients With and Without Pre-stroke Disability

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) S57 - Acute Treatment and Imaging of Ischemic Stroke (2:28 PM-2:39 PM)

Poster/Presentation
Number 009

Objective The benefit of endovascular treatment (EVT) in patients with pre-stroke disability (mRS 2 to 5) has not been systematically evaluated and warrants quantitative comparison.

Background Current guidelines recommend endovascular acute ischemic stroke (AIS) treatment for patients with no pre-stroke disability denoted as modified Rankin Score (mRS) 0 or 1.

Design/Methods Pre-stroke disability was retrospectively determined for all patients who underwent EVT for AIS between 2012 and 2018 in a prospectively-maintained registry of a single institution. Patients were trichotomized based on pre-stroke mRS: no significant (mRS 0 to 1), moderate (mRS 2 to 3), and significant disability (mRS 4 to 5). The proportion of patients who had a successful 90-day outcome, defined as no worsening of disability on the mRS scale, was compared among groups. Secondary outcomes evaluated included successful recanalization (thrombolysis in cerebral ischemia, TICI greater than or equal to 2b), symptomatic hemorrhage, and in-hospital death.

Results Pre-stroke disability could be ascertained for 247 out of 269 eligible patients. Mean age of patients with no significant (n=137), moderate (n=100), and severe disability (n=10) was 59.5, 68.5, and 59 yrs (p=0.0002) and proportion of males was 56.9%, 37.5%, and 44.4%, respectively, (p=0.01). No significant differences in baseline NIH stroke scale and time from stroke onset to recanalization were noted among these groups. Successful outcome was noted in 42% (58/137) of those with no significant, 46% (46/100) of those with moderate, and 60% (6/10) of those with significant disability (chi-square statistic 1.32, p=0.52). No significant differences were noted in the rates of symptomatic hemorrhage or successful recanalization. Proportion with in-hospital death increased with pre-stroke disability: 6.7%, 14.9%, and 33.3%, respectively, (p=0.02).

Conclusions This retrospective, single-center comparative analysis of patients with and without pre-stroke disability demonstrates similar rates of successful clinical and procedural EVT outcomes. Prospective studies are warranted to confirm this finding.

Authors/Disclosures
Sanjana Salwi PRESENTER	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
Eva A. Mistry	No disclosure on file

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