London, United Kingdom 2013 Poster Session Blue Cerebrovasc Dis 2013; 35 (suppl 3)1-854 845 943 Interventional neurology PROCEDURAL COMPLICATIONS AND LEARNING CURVE IN ENDOVASCULAR TREATMENT OF ACUTE STROKE WITH RETRIEVABLE STENTS J.A. Matias-Guiu1, C. Serna-Candel2, L. López-Ibor3, A. Gil4, P. Simal5, A.M. García-García6, C. Gómez-Escalonilla7, J. Egido8, J. Matias-Guiu95 Department of Neurology. Institute of Neurosciences, IdISSC. Hospital Clinico San Carlos, Madrid, SPAIN1, Department of Neurology. Institute of Neurosciences, IdISSC. Hospital Clinico San Carlos, Madrid, SPAIN2, Neurointerventional Unit, Department of Radiology. Hospital Clinico San Carlos, Madrid, SPAIN3, Neurointerventional Unit, Department of Radiology. Hospital Clinico San Carlos, Madrid, SPAIN4, Department of Neurology. Institute of Neurosciences, IdISSC. Hospi-tal Clinico San Carlos, Madrid, SPAIN5, Department of Neurology. Institute of Neurosciences, IdIS-SC. Hospital Clinico San Carlos, Madrid, SPAIN6, Department of Neurology. Institute of Neurosci-ences, IdISSC. Hospital Clinico San Carlos, Madrid, SPAIN7, Department of Neurology. Institute of Neurosciences, IdISSC. Hospital Clinico San Carlos, Madrid, SPAIN8, Department of Neurology. Institute of Neurosciences, IdISSC. Hospital Clinico San Carlos, Madrid, SPAIN9 Background. Retrievable stents represent an important tool in endovascular treatment of acute stroke, allowing high recanalization rates. The objective of this study is to evaluate if a learning curve in the use of retrievable stents exists, and what are the procedural complications of treatment. Methods. Data from a prospective register of patients with acute stroke treated with endovascular procedure in our centre between, where retrievable stents are the first-choice devices. Four sequen-tial groups of 20-21 patients were compared (groups I, II, III and IV) since the onset of use of re-trievable stents in a period of time of 2 years. Technical success was defined as the achievement of recanalization with the retrievable stent. Angiographic complications, haemorrhagic transformation and duration of the procedure were also measured. Results. A total of 82 patients were included (56% males, mean age 60 +/- 15 years, NIHSS 18 +/- 7). Technical success of stentrievers was achieved in 13 (76%)(I), 19 (90%)(II), 15 (79%) and 17 (100%) (p=0.06). TICI 2b/3 was obtained in 13 (65%)(I), 14 (66%)(II), 16 (76%)(III) and 17 (85%) (IV) cases (p=0.44). Complications of treatment, such as arterial dissection, embolization or vaso-spasm occurred in 1 case in each group. The duration of the procedure was 96 (I), 79.9 (II), 69.4 (III) and 78.3 (IV) minutes (p=0.47). Symptomatic haemorrhagic transformation was observed in 0 (I), 2 (9%) (II), 1 (5%) (III) and 2 (9%) (IV) patients (p=0.56). Good outcome (mRS 0-2) at 3 months was obtained in 45% (I), 52% (II), 47.6% (III) and 45% (IV) (p=0.96). Conclusions. A low rate of procedural complications was observed. There was no effect of learning in main outcomes. Regarding technical success and duration of the procedure, a trend was observed in the first patients, without influence on overall results. This fact may be important in the clinical trials design. 944 Interventional neurology Statin effect for periprocedural outcome in patients receiving carotid artery stenting J.H. Hong1, H.J. Bae2, O.K. Kwon3, G.J. Hwang4, C.W. Oh5, C. Jung6, S.I. Sohn7, J.G. Yang8, H.W. Chang9, C.H. Sohn10, M.K. Han11 Department of Neurology, Seoul National University Bundang Hospital, Seongnam, SOUTH KOREA1, Department of Neurology, Seoul National University Bundang Hospital, Seongnam, SOUTH KOREA2, Department of Neurosurgery, Seoul National University Bundang Hospital, Seongnam, SOUTH KOREA3, Department of Neurosurgery, Seoul National University Bundang Hospital, Seongnam, SOUTH KOREA4, Department of Neurosurgery, Seoul National University Bundang Hospital, Seongnam, SOUTH KOREA5, Department of Radiology, Seoul National Univer-sity Bundang Hospital, Seongnam, SOUTH KOREA6, Department of Neurology, Keimyung Univer-sity School of Medicine, Daegu, SOUTH KOREA7, Department of Neurology, Keimyung Universi-ty School of Medicine, Daegu, SOUTH KOREA8, Department of Radiology, Keimyung University School of Medicine, Daegu, SOUTH KOREA9, Department of Radiology, Seoul National University College of Medicine, Seoul, SOUTH KO-REA10, Department of Neurology, Seoul National University Bundang Hospital, Seongnam, SOUTH KOREA11 Background: We investigated whether statin use before carotid artery stenting (CAS) reduces periprocedural outcome in patients with symptomatic or asymptomatic carotid artery stenosis. Methods: We enrolled a consecutive series of 633 cases with carotid artery stenosis at two tertiary university hospital bewteen July 2003 and September 2012. CAS was indicated in symptomatic or asymptomatic patients with carotid artery stenosis of > 50% or > 60%, respectively, on conventional catheter angiography. We excluded the patients who had recent (<7 days) stroke of sufficient size to place patient at risk of hemorrhagic conversion during the procedure and who had life expectancy of less than 2 years. Definition of periprocedual outcome was composed of symptomatic stroke, myo-cardial infarction and death 1 month after and during procedure. Multiple logistic regression with the potential confounders that were significantly associated with periprocedural outcome in bivariate analysis (P<0.2) and previously reported ones was used to investigate independent factors. Results: The patients’ mean age was 68.6 years (range 20-89 years, 82.2% males). Among them, patients with any ischemic symptom within 180 days before procedure accounted for 58.6%. An-tiplatelet and lipid-lowering medication before procedure was administrated in 97.6% and 63.3%, respectively. Embolic protection device were used for embolic infarction in 86.6%. The rate of periprocedual outcome was 5.1%; 3.0% in statin user and 8.6% in non-statin user. Multivariable analyses showed a significant reduce of periprocedural outcome in statin user before CAS (OR, 0.34; 95% CI, 0.15-0.76). History of hypertension, antiplatelet use before CAS and significant con-tralateral carotid stenosis of more than 70% were further independent predictors of periprocedural outcome. Conclusion: In patients undergoing CAS, statin use before procedure may reduce periprocedural outcome.
Karger_ESC London_2013
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