Abstract
Abstract WMP6: Predictors of Times to Reperfusion in the TRACK Trevo Stent-retriever Registry
Stroke (1970), v 49(Suppl_1)
22 Jan 2018
Abstract
Abstract only
Background:
Time to mechanical thrombectomy is a significant driver of outcomes in acute ischemic stroke (AIS) patients presenting with large vessel occlusion (LVO). We aimed to evaluate predictors of onset to groin puncture (OTG), groin puncture to reperfusion (GTR), and onset to reperfusion (OTR) times in AIS patients treated with the Trevo stent-retriever.
Methods:
The investigator-initiated TRACK registry recruited 23 clinical sites to submit demographic, clinical, site-adjudicated angiographic, and outcome data on consecutive patients treated with the Trevo device. We included patients treated <8 hours from last known normal (LKN). Times for LKN, groin puncture, and TICI 2b/3 reperfusion were available to calculate OTG, GTR, and OTR times. Using multivariable linear regression, we evaluated potential predictors of times including demographics, risk factors, baseline NIHSS score, intravenous tPA use, inter-facility transfer, perfusion imaging selection, type of anesthesia, location of LVO, use of rescue intra-arterial therapies, and number of passes.
Results:
Among 433 patients analyzed (mean age 66.8 +/- 14.6 years; median NIHSS score 18; 88% anterior circulation), the median times were: OTG 240, GTR 64, and OTR 321 minutes. In multivariable analysis (Table), the independent predictors were: 1) OTG: transfer status and general anesthesia (GA) use; 2) GTR: 1 pass attempt only, use of rescue therapy, GA use, and baseline mRS >1; and 3) OTR: transfer status, use of perfusion imaging, anterior circulation LVO, use of rescue therapy, and 1 pass attempt only.
Conclusions:
Major pre-treatment contributors to delays to reperfusion in AIS patients treated <8 hours in the TRACK registry included inter-facility transfer (+82.5 minutes) and use of perfusion imaging (+30.6 minutes). Reducing inter-facility transfer delays, direct transport to thrombectomy-capable hospitals, and minimizing perfusion imaging would have major impact on reducing treatment times.
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Details
- Title
- Abstract WMP6: Predictors of Times to Reperfusion in the TRACK Trevo Stent-retriever Registry
- Creators
- Shyam Prabhakaran - Northwestern Univ, Chicago, ILOsama O Zaidat - Mercy St. Vincent Medical CenterAlicia C Castonguay - Mercy St. Vincent Medical CenterDiogo C Haussen - Emory UniversityJoey D English - California Pacific Medical CenterSudhakar R Satti - Christiana Care Health SystemJennifer Chen - Sidney Kimmel Cancer CenterHamed Farid - St. Jude Medical CenterErol Veznedaroglu - Solvo BiotechnologyMandy J Binning - Neuroscience InstituteAjit Puri - University of Massachusetts Chan Medical SchoolNirav A Vora - Riverside Radiology, Columbus, OHRon D Budzik - Riverside Radiology, Columbus, OHGuilherme Dabus - Baptist Hospital of MiamiItalo Linfante - Baptist Hospital of MiamiVallabh Janardhan - Texas Stroke Institute, Plano, TXAmer Alshekhlee - DePaul Stroke Cntr-SSM Neuroscience Institutes, St. Louis, MOMichael G Abraham - University of KansasRandall Edgell - Saint Louis UniversityAsif Taqi - Los Robles Hospital & Medical CenterRamy El Khoury - Tulane UniversityMaxim Mokin - University of South FloridaAniel Q Majjhoo - Wayne State UniversityMouhammed Kabbani - Gundersen Health SystemMichael T Froehler - Vanderbilt UniversityIra Finch - John Muir HealthSameer A Ansari - Northwestern UniversityRoberta Novakovic - The University of Texas Southwestern Medical CenterThanh N Nguyen - College Station Medical CenterRaul G Nogueira - Emory University
- Publication Details
- Stroke (1970), v 49(Suppl_1)
- Resource Type
- Abstract
- Language
- English
- Academic Unit
- Neurology; Neurosurgery
- Other Identifier
- 991021918111004721