London, United Kingdom 2013 Poster Session Blue Cerebrovasc Dis 2013; 35 (suppl 3)1-854 639 558 Acute stroke: emergency management, stroke units and complications Stroke-related Trauma: A missed opportunity for time critical treatments? A. Asokanathan1, A.Y. Allan2, S. Sethuraman3, D. Phiri4, L. Sekaran5 Luton and Dunstable NHS Foundation Trust, Luton, UNITED KINGDOM1, Luton and Dun-stable NHS Foundation Trust, Luton, UNITED KINGDOM2, Luton and Dunstable NHS Foundation Trust, Luton, 3, Luton and Dunstable NHS Foundation Trust, Luton, UNITED KINGDOM4, Luton and Dunstable NHS Foundation Trust, Luton, UNITED KINGDOM5 Aim: Trauma and / or evidence of non-intracranial bleeding is generally considered a relative con-traindication for intravenous thrombolytic therapy in acute ischemic stroke. There is currently no clear evidence regarding their management. The aim of this study was to determine the incidence and nature of the stroke-related trauma and its influence on treatment of patients. Methods: Patients with stroke-related trauma were identified among all acute stroke patients admit-ted during a one year period (09/11-09/12) in our centre. The nature and influence on thrombolytic therapy were reviewed by history, physical examination, imaging findings and medical notes. Results: Nine patients with stroke-related trauma were identified among 543 stroke patients. Six sustained limb fractures and three suffered soft tissue injury. Of the six limb fractures, three had multiple fractures, and one patient with soft tissue injury had a haematoma over the forehead. 4 out of 9 stroke-related trauma patients were considered appropriate for thrombolytic therapy. Conclusions: All stroke-related trauma included in our study are due to falls as a result of stroke. The majority of patients (six out of nine) had limb fractures, of which half had multiple fractures. Three out of nine were offered thrombolytic therapy and one was inappropriately excluded. We feel that patients suffering stroke-related injuries should be assessed on an individual basis, and not ex-cluded from consideration of thrombolytic therapy solely on the basis of a history of trauma. 559 Acute stroke: emergency management, stroke units and complications MULTIMODAL ENDOVASCULAR TREATMENT PERFORMANCE IN BASILAR OCLU-SION DEPENDS ON ETIOLOGY H. QUESADA1, P. CARDONA2, l. CANO3, L. AJA4, S. AIXUT5, R. BARRANCO6, M.A. DE MIQUEL7, F.R. RUBIO8 HOSPITAL UNIVERSITARI DE BELLVITGE. Stroke Unit. Neurology Department. IDI-BELL., BARCELONA, SPAIN1, HOSPITAL UNIVERSITARI DE BELLVITGE. Stroke Unit. Neurology Department. IDIBELL., BARCELONA, SPAIN2, HOSPITAL UNIVERSITARI DE BELLVITGE. Stroke Unit. Neurology Department. IDIBELL., BARCELONA, SPAIN3, HOSPITAL UNIVERSITARI DE BELLVITGE. Radiology Department. IDIBELL., BARCELONA, SPAIN4, HOSPITAL UNIVERSITARI DE BELLVITGE. Radiology Department. IDIBELL., BARCELO-NA, SPAIN5, HOSPITAL UNIVERSITARI DE BELLVITGE. Radiology Department. IDIBELL., BARCELONA, SPAIN6, HOSPITAL UNIVERSITARI DE BELLVITGE. Radiology Department. IDIBELL., BARCELONA, SPAIN7, HOSPITAL UNIVERSITARI DE BELLVITGE. Stroke Unit. Neurology Department. IDIBELL., BARCELONA, SPAIN8 BACKGROUND Acute basilar artery occlusion is a devastating condition associated with poor clinical outcome, spe-cially if no treatment is performed or recanalisation is not achieved. However the optimal approach to BAO has not still been setted, since most studies analyse only anterior circulation or all territories strokes. The aim of our study is to describe and analyse the performance of multimodal treatment of BAO in our centre and recanalisation according to etiology. METHODS This study is based in a prospectively collected cohort of a single comprehensive stroke centre. Cri-teria to undergo thrombectomy includes basal mRS score <2, <12 hours or <24 from stroke onset if fluctuating symptoms are developed and <80 years old. Diagnosis of BAO is made with AngioCT. Multimodal treatment is chosen according to radiologist preferences. Recanalisation status is consid-ered if TICI 2b o 3 and good clinical outcome is considered if mRS <3 at 90 days. TOAST etiology and also embolic mecanism (EM) of oclusion (cardioembolic or artery-artery atherotrombotic embo-lism) versus intracranial occlusive disease (IOD) is analysed. RESULTS Twenty-seven consecutive patients with BAO are prospectively analysed from April 2010 to De-cember 2012. Baseline characteristics are as follow (table 1) Recanalisation is achieved in 60% of patients and good clinical oucome at 90 days in 14.81%. Local rtPA is used in 3 patients, angioplasty in 10, stent placement in 5 and retrievable stents in 15. Stroke etiology (TOAST): large vessel disease, 70,37; cardioembolic 11,11%; undetermined 14.81% and 1 other etiology. IOC is the etiology of 48,14% and has a recanalisation rate of 38.46%, against 90.90% of recanalisation in EM (p 0.01). No differences in recanalisation status are found according to TOAST criteria nor device used. Predictors of good outcome are not found. CONCLUSION EM of BAO is related to recanalisation in opposition to IOD. No specific approach is related to re-canalisation. Table 1. BASELINE CHARACTERISTICS Males (%) 85 Age (median; SD) 63; 10 mRS 0 (%) 81 NIHSS score (median; SD) 19; 10 Awakening stroke (%) 29.63 Systemic rtPA (%) 37 General anesthesia (%) 40
Karger_ESC London_2013
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