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22. European Stroke Conference 7 Acute stroke: current treatment Radiographic Predictors Of Major Neurologic Improvement After Mechanical Thrombectomy In Acute Stroke J.A Desai1, 2, M.A Almekhlafi3, S Mishra4, V Nambair5, M Eesa6, B.K Menon7, O Volny8, M Goy-al9, A.M Demchuk10 University of Calgary, Calgary, CANADA1, , , 2, University of Calgary, Calgary, CANADA3, Uni-versity of Calgary, Calgary, CANADA4, University of Calgary, Calgary, CANADA5, University of Calgary, Calgary, CANADA6, University of Calgary, Calgary, CANADA7, University of Calgary, Calgary, CANADA8, University of Calgary, Calgary, CANADA9, University of Calgary, Calgary, CANADA10 Background: The Solitaire and Trevo Retrievers are novel self-expanding stent like devices designed to rapidly restore flow in acute ischemic strokes. The objective of the present study is to identify radiographic predictors of major neurologic improvement (MNI defined as ≥50% improvement in NIHSS score within 24h) in acute ischemic stroke patients treated with mechanical thrombectomy. Methods: This is a longitudinal cohort of anterior circulation acute ischemic stroke patients treated with stentriever devices at a quaternary stroke center. Patient demographics, radiologic and clinical data were collected. Percent improvement (Baseline NIHSS -24h-NIHSS)/baseline NIHSS X 100 was calculated. We tested differences between groups using the Chi-squared test for categorical vari-ables and the Kruskal-Wallis test for continuous variables. Subsequent univariate analysis was per-formed using logistic regression. Results: Results are summarized in Table1. Favorable ASPECTS >5 (p=0.003) at baseline and at 24hours (p=0.011); successful recanalization by conventional an-giography (0.044); and grade TICI32C/3 reperfusion was associated with MNI. ICH at 24 hours (HI-2/PH1/PH2/sICH) by SITS-MOST criteria (p=0.017) and TICI2b reperfusion were associated with poor neurologic improvement (PNI). In univariate logistic regression analysis favorable base-line ASPECTS (OR 5.05, p=0.006, 95%CI 1.6-15.9); favorable 24h-ASPECTS (OR2.94, p=0.012, 95%CI 1.27-6.82); Successful recanalization (OR 2.63, p=0.048, 95%CI 1.01-6.86); and TICI2c/3 (OR5.22, p<0.0001, 95%CI 2.08-13.09) remained predictive of MNI. TICI2b (OR 0.041, p=0.035, 95%CI 0.18-0.94) and ICH on 24h scan (OR 0.32, p=0.02, 95%CI 0.12-0.84) were associated with PNI. Conclusion: Favourable baseline ASPECTS are predictive of MNI and should be considered while selecting patients for mechanical recanalization. TICI2c/3 perfusion is associated with MNI and future research should look at techniques and strategies to optimize recanalization. 280 © 2013 S. Karger AG, Basel Scientific Programme Table1: Radiographic variables associated with Major clinical im-provement post-mechanical thrombectomy. Minimal cli-nical impro-vement (<50% change in NIHSS from baseline) Major cli-nical im-provement (>50% change in NIHSS) P 38 67 Median baseline NIHSS(I-QR) 17.5(7) 17 (8) 0.513 Proportion favorable AS-PECTS (Score 6-10) 71.05% 92.54% 0.003* Proportion favorable colla-terals (Total collateral sco-re> 2) 34.38% 32.26% 0.836 Proportion Successful Recanalization (2b-3) 68.42% 85.07% 0.044* Proportion TICI0 or TICI1 reperfusion 15.79% 7.46% 0.180 Proportion TICI2A reperfu-sion 15.79% 7.46% 0.180 Proportion TICI 2B reperfu-sion 47.37% 26.87% 0.033* Proportion TICI2C/3 reper-fusion 21.05% 58.21% Proportion 24Hr Favorable 50.00% 74.63% 0.011* ASPECTS (Score 6-10) Proportion with ICH (HI- 2,PH1,PH2 SITS-MOST de-finition) at 24hr scan 37.14% 15.87% 0.017*


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