22. European Stroke Conference 15 Acute stroke: current treatment Mechanical endovascular treatment of basilar artery occlusion J.A. Matias-Guiu1, C. Serna-Candel2, A. Gil3, L. López-Ibor4, A.M. García5, P. Simal6, C. Gó-mez- Escalonilla7, J.A. Egido8, J. Matias-Guiu9 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 Clini-co San Carlos, Madrid, 4, Department of Neurology. Institute of Neurosciences, IdISSC. Hospital Clinico San Carlos, Madrid, SPAIN5, Department of Neurology. Institute of Neurosciences, IdISSC. Hospital Clinico San Carlos, Madrid, SPAIN6, Department of Neurology. Institute of Neurosciences, IdISSC. Hospital Clinico San Carlos, Madrid, SPAIN7, Department of Neurology. Institute of Neu-rosciences, IdISSC. Hospital Clinico San Carlos, Madrid, SPAIN8, Department of Neurology. Insti-tute of Neurosciences, IdISSC. Hospital Clinico San Carlos, Madrid, SPAIN9 Background. Acute stroke due to basilar artery occlusion is associated to poor outcome. Random-ized clinical trials regarding the best treatment are lacking. Retrievable stents have demonstrated a high recanalization rate, but data in posterior circulation are scarce. Methods. Data from a prospective register of patients with acute stroke treated with endovascular procedure in a single centre between 2009-2011 were analysed. Patients with basilar artery occlu-sion were selected. GCS 3-4 was used to define a severe stroke situation. Results. A total of 23 patients (65% male) were included: median age 63 years range 28-86; median base-line NIHSS 21 range 3-42. 9 (39%) patients were classified as severe. The etiology of stroke was cardioembolism in 7 cases and atherothrombosis in 9. Six patients received previous intravenous thrombolysis. Median time from stroke to treatment was 310 range 145-1380 minutes. Devices used were retrievable stents in 16 cases and intracranial stents in 7. Median procedure duration was 98 range 24-280 minutes. TICI 2a was obtained in 7 cases (30%), and TICI 2b or 3 in 14 (60%). Parenchymal haemorrhagic transformation occurred in 2 patients (8.6%). Good outcome (mRS 2 or less) was achieved in 8 cases (34.8%). Mortality occurred in 11 cases (47.8%). In the group with a more severe stroke situation, good outcome was obtained in 22%, but mortality was 66%. Cardio-embolism was associated to a greater use of retrievable stents (7, 100%) in comparison to athero-thrombotic etiology (3, 37.5%) (p=0.01), as well as a better outcome (mRS 0-2 at 3 months in 71% vs 22%, respectively). Conclusions. Endovascular treatment of basilar artery occlusion is safe and effective, even in patients with severe stroke. Retrievable stents allow good results, especially in cardioembolic stroke, but their use in ath-erothrombosis 284 © 2013 S. Karger AG, Basel Scientific Programme is limited. 16 Acute stroke: current treatment Prognostic factors of outcome in thrombolysed cases of acute ischemic stroke (AIS) at a tertia-ry care center in India P. AGARWAL1, R. REDDI2, J.D. MUKHERJI3, M. KUMAR4, O. SINGH5, B. WALIA6, N. K.SINGH7, T. AHLUWALIA8, Y. JAVERI9, P. BAJAJ10, V. Rai11 MAX SUPERSPECIALITY HOSPITAL, N DELHI, INDIA1, MAX SUPERSPECALITY HOS-PITAL, N DELHI, INDIA2, MAX SUPERSPECIALITY HOSPITAL, N DELHI, INDIA3, MAX SUPERSPECIALITY HOSPITAL, N DELHI, INDIA4, MAX SUPERSPECIALITY HOSPITAL, N.DELHI, INDIA5, MAX SUPERSPECIALITY HOSPITAL, N DELHI, INDIA6, MAX SUPER-SPECIALITY HOSPITAL, N DELHI, INDIA7, MAX SUPERSPECIALITY HOSPITAL, N DEL-HI, INDIA8, MAX SUPERSPECIALITY HOSPITAL, N.DELHI, INDIA9, MAX SUPERSPECIALITY HOSPITAL, N DELHI, INDIA10, MAX SUPERSPECIALITY HOSPI-TAL, N DELHI, INDIA11 Aim:To analyze the prognostic factors of outcome in thrombolysed cases of AIS at a tertiary care centre. Materials and Methods: 2450 cases of acute stroke were admitted from July 2006 to De-cember 2012.2035(83.06%)were of AIS and 415(16.93%)were hemorrhagic.144(7.07%)cases of AIS were thrombolysed with in 6 hrs of stroke.115(79.86%) with IV r-tPA(22 were between 3-4.5 hrs)19(13.19%)sonothrombolysed,6(4.16%)intra arterial thrombolysis and 4(2.77%)bridging throm-bolysis. Mean time to reach hospital was 128 min(45 - 295),mean door to MRI brain time 22.5 min(15-35)mean door to needle time 32.5 min(22- 50)and mean time to treat(TT)160.5 min(70 - 330).The primary outcome was 4 points change in NIHSS,MRS score(< or = 2),mortality at 7th day and three months.Results:The mean age was 62 +/- 9.8 years.92(63.88%)(p < 0.05)had signif-icant improvement on NIHSS(mean change-8)at 7th day(p< 0.05).68 patients were assessed at 3 months,48(70.58%)(p < 0.05)had better outcome(MRS</ =2).40 cases having early improvement at 7th day had better outcome(MRS </=2)at 3 months (p<0.05).There was significant recovery(p < 0.05)in NIHSS and MRS score who had TT<2hrs,HDL>40 mg%,sonothrombolysed,B.P<170/100, b.sugar<140 mg% and NIHSS<18.There was bad outcome in ICA or MCA occlusion(p< 0.05). In MCA stroke,3 (3/4) (75%) had good outcome with bridging thrombolysis than1 patient(1/7 = 14.28%) with IV thrombolysis.7 (4.86%) had asymptomatic hemorrhage (ICH),2 had lobar hem-orrhage. B.P was > 170/100 in 80% of hemorrhage (p<0.05).One (1.44%) died within 7 days.Con-clusion: There was better outcome in thrombolysed patients at 7th day and majority had favorable recovery at 3 months also.Good prognostic factors were TT< 2 hrs,HDL> 40 mg%,B.P<170/100,b. sugar<140 mg% NIHSS<18 and sonothrombolysis.Sonothrombolysis is better than IV thrombolysis in selected cases.Bad prognostic factors were ICA and MCA occlusion.High B.P was a risk factor for ICH.Keywords:r-tPA,acute ischemic stroke,intravenous thrombolysis,sonothrombolysis,intraar-terial thrombolysis,bridging thrombolysis,prognostic factors,door to needle time,time to treat
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