Abstract
Abstract WP8: Global Real World Evidence of Balloon Guided Stent Retriever Thrombectomy
Stroke (1970), v 49(Suppl_1)
22 Jan 2018
Abstract
Abstract only
Background and Aims:
Balloon Guide Catheter (BGC) use during thrombectomy treatment in Stroke patients has been reported to have positive effects on revascularization, procedural characteristics, and clinical outcomes. We evaluate the use of BGC in an open-label large prospective TREVO Retriever Registry of real world patients to determine predictors of good ‘clinical’ outcomes.
Method:
Consecutive Trevo Registry patients that had Balloon Guide Catheter (BGC) used during their thrombectomy procedure were identified; a subset of patients who fulfilled the criteria (ICA and/or MCA-M1/M2 occlusion with pre-morbid mRS 0-1, TLSW ≤6 hrs) within the cohort were also identified. Multivariate analysis was performed to identify the predictors of good outcomes in BGC thrombectomy patients.
Results:
A total of 1031 BGC treated Trevo Registry patients (overall enrolled, n=2010) qualified for analysis, of which 605 patients fulfilling the subset criteria were identified. The mean age of BGC/stent retriever patients was 67.5 with a median (IQR) baseline NIHSS of 15(11-19). Occlusion location of the BCG group was ICA -20.4%, M1- 57.1%, M2/M3-20.3%, and Posterior 1.8%.
In the overall BGC cohort, the median (IQR) time to treatment was (4.2 (3.0,6.5)- hrs.) with conscious/local sedation used in 63.4% and general anesthesia used in 37.3% of cases. The median number of passes with Trevo stent retriever was 1 and revascularization (mTICI ≥ b) was achieved in 92.8% of cases. The sICH rate was low at 1.9% (20/1031) with a low rate of vessel perforation (0.2%). At 90 days post stroke, 56.0% of patients achieved functional independence (mRS 0-2) with 63.7% of the subset of “guidline “ BGC patients achieving functional independence at 90 days. Multivariate logistic regression showed age (aOR 0.97 [0.96, 0.99] P <0.001), Diabetes (aOR 0.67, [0.18,0.98] P =0.03), conscious sedation vs general anesthesia ( aOR 1.7 [1.2,2.3], P= 0.002, number of passes (aOR 0.76 [0.66-0.88],P <0.001), pre stroke mRS (aOR 0.54 [0.45-0.65], P <0.0010 and NIHSS (aOR 0.93 [0.91-0.95], P <0.001) as predictors of functional independence .
Conclusion:
Data from Trevo Registry demonstrate the use of BGC in thrombectomy procedure is safe, and leads to a reduction of disability in ischemic stroke patients.
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Details
- Title
- Abstract WP8: Global Real World Evidence of Balloon Guided Stent Retriever Thrombectomy
- Creators
- Hormozd Bozorgchami - Oregon Health & Science UniversityRyan Priest - Oregon Health & Science UniversityErol Veznedaroglu - Neurosciences InstituteDavid Liebeskind - Neurovascular Imaging Res Core, Los Angeles, CARonald Budzik - OhioHealthBlaise Baxter - Erlanger Health SystemBruno Bartolini - Pitié-Salpêtrière HospitalRyan Shields - StrykerAntonin Krajina - University of Hradec KrálovéAmrou Sarraj - Memorial HermannRishi Gupta - WellStar Health SystemRaul Nogueira - Grady Memorial HospitalAli Malek - St. Mary's Medical CenterJoey English - California Pacific Medical CenterMasahiro Horikawa - Oregon Health & Science UniversityTrevo Retriever Registry Investigators
- Publication Details
- Stroke (1970), v 49(Suppl_1)
- Resource Type
- Abstract
- Language
- English
- Academic Unit
- Neurosurgery
- Other Identifier
- 991021962190204721