London, United Kingdom 2013 3 Interventional neurology B 8:50 - 9:00 Outcomes of a large, contemporary cohort of Acute Ischaemic Stroke Patients Treated with Endovascular Procedures under Routine Practice Conditions. The Cat-SCR initia-tive S. Abilleira1, P. Cardona2, M. Ribó3, M. Millán4, V. Obach5, J. Roquer6, D. Cánovas7, J. Martí-Fábregas8, F. Rubio9, J. Álvarez-Sabín10, A. Dávalos11, Á. Chamorro12, A. Ribera13, M. Gallofré14 on behalf of the Catalan Stroke Code and Reperfusion Consortium (Cat-SCR). Stroke Programme. Catalan Agency for Health Information, Assessment and Quality. Department of Health (Catalonia), Barcelona, SPAIN1,Cat-SCR members, L’Hospitalet, SPAIN2, Cat-SCR members, Barcelona, SPAIN3, Cat-SCR members, Badalona, SPAIN4, Cat- SCR members, Barcelona, SPAIN5, Cat-SCR members, Barcelona, SPAIN6, Cat-SCR members, Sabadell, SPAIN7, Cat-SCR members, Barcelona, SPAIN8, Cat-SCR members, L’Hospitalet, SPAIN9, Cat-SCR members, Barcelona, SPAIN10, Cat-SCR members, Badalona, SPAIN11, Cat-SCR members, Barcelona, SPAIN12, Stroke Programme. Catalan Agency for Health Information, Assessment and Quality. Department of Health (Catalonia), Barcelona, SPAIN13, Stroke Pro-gramme. Catalan Agency for Health Information, Assessment and Quality. Department of Health (Catalonia), Barcelona, SPAIN14 Background: We sought to describe outcomes after endovascular therapies (EVT) in a large, contemporary (Jan 2011 – Nov 2012) cohort of AIS patients treated under routine practice con-ditions in a closed territory (7.5 million inhabitants). Additionally, we aimed at describing dif-ferences in effectiveness according to patients’ subgroups. Methods: We used data from the SONIIA register, a mandatory and externally audited register that monitors quality of reperfusion therapies in Catalonia. Seven hospitals carry out EVTs and include relevant data in the register. We analysed safety and effectiveness measures within the overall EVT cohort and by patients’ subgroups: combined IVT+EVT vs. primary EVT; anterior circulation vs. posterior circulation strokes; recanalisation (post-EVT TICI score 2b-3) vs. no recanalisation; age <= 80 vs. > 80; and onset-to-treatment time (OTT) <= 6 hours vs. > 6 hours post-stroke. Results: We analysed 506 AIS patients, of whom 272 underwent combined IVT+EVT and 234 had primary EVTs. Mean age: 67.9±13.4; males: 278 (54.9%); baseline NIHSS: 17 (13-21); an-terior circulation strokes: 443 (87.6%); age <=80: 427 (84.4%); OTT <= 6 h: 361 (71.5%); and post-EVT TICI 2b-3: 371 (73.6%). Overall, 27 (5.4%) cases developed SICHs, 221 (47.2%) were independent at 3 months and 95 (18.8%) were dead at 90 days. Patients >80 years and those who did not achieve angiographic recanalisation showed significantly higher death rates (29% vs. 17%, p< 0.01; 36% vs. 12.7%, p < 0.001), and reduced odds of functional indepen-dence (25.4% vs. 51%, p< 0.001; 18.2% vs. 57.1%, p< 0.001). Patients with OTT> 6 hours had fewer chances of achieving recanalisation (65.6% vs. 77.2%, p< 0.01) and being independent at 3 months (40.3% vs. 50%, p= 0.06). Conclusions: This study shows acceptable outcomes overall and some significant differences according to patients’ subgroups that might guide selection of patients for neurointervention-ism. Cerebrovasc Dis 2013; 35 (suppl 3)1-854 177 2 Interventional neurology B 8:40 - 8:50 Predictors of artery recanalization after endovascular treatment of the occluded cerebral artery in acute ischemic stroke patients: multivariate logistic regression analysis D. Skoloudik1, M. Roubec2, M. Kuliha3, D. Sanak4, T. Veverka5, M. Kral6, M. Kocher7, V. Prochazka8, R. Herzig9, K. Langova10 Palacky University Olomouc, Olomouc, CZECH REPUBLIC1,University Hospital Ostrava, Ostrava, CZECH REPUBLIC2, University Hospital Ostrava, Ostrava, CZECH REPUBLIC3, University Hospital Olomouc, Olomouc, CZECH REPUBLIC4, University Hospital Olomouc, Olomouc, CZECH REPUBLIC5, University Hospital Olomouc, Olomouc, CZECH REPUB-LIC6, University Hospital Olomouc, Olomouc, CZECH REPUBLIC7, University Hospital Ostrava, Ostrava, CZECH REPUBLIC8, University Hospital Olomouc, Olomouc, CZECH RE-PUBLIC9, Palacky University Olomouc, Olomouc, CZECH REPUBLIC10 Background: Early recanalization of brain artery occlusion predicts 3-month independency in acute ischemic stroke (AIS) patients. Mechanical recanalization methods are experimentally tested in AIS treatment. The study aimed to find predictors of recanalization grade in AIS pa-tients undergoing mechanical recanalization. Methods: Consecutive AIS patients with brain artery occlusion treated with mechanical recanal-ization were included in the retrospective study. Stroke severity was assessed using National In-stitutes of Health Stroke Scale (NIHSS). Artery recanalization was quantified using Thrombol-ysis in Cerebral Ischemia (TICI) scale. Influence of vascular risk factors, blood pressure, levels of blood glucose and cholesterol at admission, type of used therapy, occlusion location, stroke severity and etiology on recanalization TICI grade were statistically evaluated using Spearman coefficient, Mann-Whitney and Kruskal-Wallis tests. Multivariate logistic regression analysis was used to test the predictive power of particular variables. Results: Study set consisted of 372 patients (55% males, mean age 64.3±13.1 years) with me-dian baseline NIHSS score 16 (5-30) points. Any artery recanalization was achieved in 83.9% patients, complete recanalization (TICI 3) in 43.5% patients. NIHSS score negatively correlated with TICI grade (r=-0,230, P<0.001). Patients with atrial fibrillation (AF) presented with lower recanalization grade than patients without AF (P=0.007). Multivariate logistic regression analy-sis identified only baseline NIHSS value (OR: 0.921, 95% CI: 0.878-0.967, P =0.001) as a pre-dictor of complete recanalization. Conclusion: Only NIHSS score at admission was identified as an independent predictor of com-plete recanalization in AIS patients treated with mechanical recanalization methods. Acknowledgement: Supported by IGA MH CR grants NT/11386-5/2010, NT/11046-6/2010, NT 13498-4/2012.
Karger_ESC London_2013
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