London, United Kingdom 2013 Poster Session Blue Cerebrovasc Dis 2013; 35 (suppl 3)1-854 831 916 Interventional neurology Artery dissection and stroke. Incidence, clinical picture, management, and outcome. Retro-spective study. V. Nosal1, K. Zelenak2, S. Sivak3, J, Michalik4, J. Zelenakova5, E. Kurca6 Neurology Clinic CU JLF And University Hospital in Martin, Martin, SLOVAKIA1, Radiolo-gy Clinic CU JLF And University Hospital in Martin, Martin, SLOVAKIA2, Neurology Clinic CU JLF University Hospital in Martin, Martin, SLOVAKIA3, Neurology Clinic CU JLF And Universi-ty Hospital in Martin, Martin, SLOVAKIA4, Neurology Clinic CU JLF And University Hospital in Martin, Martin, SLOVAKIA5, Neurology Clinic CU JLF And University Hospital in Martin, Mar-tin, SLOVAKIA6 Background:Artery dissection (DIS) is considered as a relatively rare case of the stroke. We present analysis of DIS incidence, clinical picture, management, and outcome of the patients in our centre. Methods: Retrospective analysis of the patients with artery DIS (internal carotid artery (ICA), ver-tebral artery (VA), middle cerebral artery (MCA), and basilar artery (BA)), who were hospitalised at our department during years 2009 - 2012. Results:15 patients (9 male and 6 female) were enrolled. Average age was 44.8 years (17-70). From 22 identified DIS 19 were endovascularly treated, 3 were treated conservatively. Only 6 DIS were found as an isolated serious vascular pathology (all were left ICA), the rest were combined as fol-lows: 1 ICA DIS + contralateral ICA occlusion, 1 ICA and MCA DIS, 1 bilateral ICA and unilateral MCA DIS, 1 bilateral ICA DIS and unilateral VA occlusion, 1 bilateral ICA DIS, bilateral VA DIS, 1 unilateral VA DIS and contralateral VA occlusion, 1 BA DIS, 1 VA and BA DIS. 9 patients had spontaneous DIS, 5 cases had history of recent trauma and in one case severe cough was noted. Only in 4 cases treatment was acute (in average 5 hours from the onset of symptoms or trauma), 11 patients were treated 2-7 days from the onset of symtoms. This corresponds with CT/MRI finding - 5 patients had negative finding on initial CT or MRI, 10 patients had ischemic lesion identified. No characteristic clinical picture was usually found, except 3 cases with typical headache or neck pain. There was 1 asymptomatic DIS as an incidental finding, the rest of the patients had from mild to severe neurologic deficit depending on the affected artery and stroke or trauma severity. 9 patients significantly improved after treatment, in 4 cases there was no change after treatment (however all were with mild deficit), 1 patient died (patient with VA DIS followed with BA thrombosis), and there was 1 procedure related complication - carotid-cavernous fistula. Conclusion:DIS is rare case of the stroke, but possible especially in younger population. Artery DIS is not usually isolated. En-dovascular treatment is safe and effective treatment. Supported with ITMS No:26110230067 917 Interventional neurology Evaluation of the bridging concept as treatment option in endovascular stroke treatment. L. Fjetland1, K.D. Kurz2, S. Roy3, M.W. Kurz4 Department of Radiology, Stavanger University Hospital, Stavanger, NORWAY1, Department of Radiology, Stavanger University Hospital, Stavanger, NORWAY2, Department of Radiology, Stavanger University Hospital, Stavanger, NORWAY3, Department of Neurology, Stavanger Univer-sity Hospital, Stavanger, NORWAY4 PURPOSE: Intraarterial therapy (IAT) is increasingly used as treatment option for acute stroke caused by central large vessel occlusions. It is an ongoing discussion whether patients presenting within the first 4.5 hours should be pretreated with intravenous thrombolysis (IVT) before continu-ing with IAT (bridging concept). The authors evaluate the bridging concept used as standard concept at the Stavanger University Hospital (SUS). MATERIALS AND METHODS: All patients treated at SUS with IAT from May 2009 to Octo-ber 2012 were included in this study. All patients presenting within 4.5 hours with an acute stroke caused by a large vessel occlusion and no contraindications for IVT were pretreated with IVT prior to IAT. We analyzed the proportion and characteristics of patients that got a recanalization already by pretreatment with IVT. RESULTS: 81 patients were evaluated in this study. In 62 of the patients IAT (76.5%) had been per-formed. In 12 patients (14.8%) only angiography was performed as they exhibited recanalization due to IVT, in three patients (3.7%) IAT was not performed due to clinical reasons and in 4 patients (4.9%) it was technically not possible to accomplish IAT. Patient characteristics and safety details are presented. CONCLUSIONS: Bridging therapy seems to be a safe and feasible concept in acute stroke treat-ment. In our patient group 14.8% got a recanalization of the prior occluded vessel due to IVT. As time is crucial for good patient outcome bridging therapy is recommended as concept for IAT.
Karger_ESC London_2013
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