22. European Stroke Conference 9 Interventional neurology B 9:50 - 10:00 Predictors of clinical outcome after endovascular stroke treatment for anterior circulation large vessel occlusion patients ≥ 80 years W. Kurre1, M. Aguilar-Pérez2, L. Niehaus3, S. Fischer4, E. Schmid5, H. Bäzner6, H. Henkes7 Neuroradiologie Klinikum Stuttgart, Stuttgart, GERMANY1,Neuroradiologie Klinikum Stuttgart, Stuttgart, GERMANY2, Neurologie Klinikum Schloss Winnenden, Winnenden, GER-MANY3, Neuroradiologie Klinikum Stuttgart, Stuttgart, GERMANY4, Neurologie Klinikum Stuttgart, Stuttgart, GERMANY5, Neurologie Klinikum Stuttgart, Stuttgart, GERMANY6, Neu-roradiologie Klinikum Stuttgart, Stuttgart, GERMANY7 Purpose: There is uncertainty about the role of endovascular recanalization for treatment of acute ischemic stroke in patients ≥ 80 years. Therefore careful patient selection is mandatory. We aimed to find valid predictors for clinical outcome based on the sparse information avail-able in the emergency setting to facilitate decision making. Methods: All patients ≥ 80 years treated endovascularly for anterior circulation stroke between January 2008 and July 2012 were included consecutively. Successful recanalization was defined as a TICI 2b or 3 score. Paren-chymal hemorrhages type I and II (PHI, PHII) and the rate of diffuse SAH were reported. A 90 days mRS of 0-2 or equal to pre stroke disability served as a measure for good clinical out-come. We evaluated the influence of Totaled Health Risks in Vascular Events (THRIVE) and ASPECT scores on good clinical outcome using Fisher´s exact test. Potential predictors were included in a logistic regression analysis. P-values ≤ 0.05 were considered statistically signif-icant. Results: Successful recanalization was achieved in 74 of 85 patients (87.1%). The rates of PH I, PHII and diffuse SAH were 7.1%, 4.7% and 7.1 % respectively. Despite good reca-nalization rates and reasonable rates of hemorrhage only 12 (14.1%) patients had good clinical outcome. The THRIVE score (OR 0.57 (95% CI: 0.37-0.88), p=0.012) and ASPECT score (OR 1.64 (95% CI: 1.14-2.36), p=0.008) predicted clinical outcome in a univariate analysis. Logis-tic regression including THRIVE and ASPECT scores revealed both as independent predictors for good outcome (THRIVE : OR 0.1 (95% CI: 0.41-0.92); p=0.019, ASPECT: OR 2.05 (95% CI: 1.03-4.08); p=0.041). Conclusion: The chance of good clinical outcome after endovascu-lar treatment of anterior circulation stroke in geriatric patients is limited but still rewarding. Pre-treatment THRIVE and ASPECT scores were independent predictors for good outcome and may guide decision making in the emergency situation. 8 Interventional neurology B 9:40 - 9:50 Histological features of thrombo-embolic specimens collected from intracranial arteries of patients with acute ischemic stroke F. Sallustio1, G. Koch2, S. Di Legge3, N. Arnò4, D. Samà5, A. Giordano6, E. Pampana7, M. Stefanini8, D. Konda9, C.A. Reale10, A. Spinelli11, A. Mauriello12, P. Stanzione13, R. Gandini14 Stroke Unit, University of Tor Vergata, Rome, ITALY1,Stroke Unit, University of Tor Ver-gata, Rome, ITALY2, Stroke Unit, University of Tor Vergata, Rome, ITALY3, Stroke Unit, Uni-versity of Tor Vergata, Rome, ITALY4, Stroke Unit, University of Tor Vergata, Rome, ITALY5, Stroke Unit, University of Tor Vergata, Rome, ITALY6, Department of Diagnostic Imaging and Interventional Radiology, University of Tor Vergata, Rome, ITALY7, Department of Diagnostic Imaging and Interventional Radiology, University of Tor Vergata, Rome, ITALY8, Department of Diagnostic Imaging and Interventional Radiology, University of Tor Vergata, Rome, ITALY9, Department of Diagnostic Imaging and Interventional Radiology, University of Tor Vergata, Rome, ITALY10, Department of Diagnostic Imaging and Interventional Radiology, University of Tor Vergata, Rome, ITALY11, Department of Anatomic Pathology, Unoversity of Tor Vergata, Rome, ITALY12, Stroke Unit, University of Tor Vergata, Rome, ITALY13, Department of Diag-nostic Imaging and Interventional Radiology, University of Tor Vergata, Rome, ITALY14 Background: Intracranial arteries occlusions account for about 70% of acute ischemic strokes. Histological analysis of thromboemboli, together with evaluation of clinical and histological correlations, could provide critical informations regarding pathogenesis and prevention therapy. Methods: Thromboemboli were retrieved by endovascular mechanical thrombectomy devices from major arteries of the circle of Willis of patients with acute ischemic stroke. Total thrombus area and percentage of fibrin were calculated. Results: 28 thrombi retrieved from 28 patients were analyzed. 3 patterns of thrombus histolo-gy were identified based on fibrin architecture: serpentine (15/28), layered (11/28) and red clot (2/18: with no fibrin interspersed). No differences in stroke etiology were found between differ-ent histological patterns (based on TOAST criteria the two red clot were both classified as large artery). Comparing serpentine and layered patterns, the latter showed a significantly higher percentage of fibrin (70.5 vs 40.3, p=0.03), significantly higher pre-treatment National Insti-tute of Health Stroke Scale (NIHSS) score (21 vs 17.7, p=0.02), a significantly shorter onset to recanalization time (286 min vs 356 min, p=0.02), while no differences were found in clinical outcome nor in symptomatic intracranial haemorrhage (sICH). Thrombus area showed to be higher in cases with multiple vessels involvement (p=0.046), with sICH (p=0.026), with worst 3 months outcome (p=0.04) and mortality (p=0.029). Conclusion: Histological analysis of thromboemboli proved useful in the identification of spe-cific patterns and their behaviour in terms of response to endovascular treatment and clinical outcome. 180 © 2013 S. Karger AG, Basel Scientific Programme
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