Abstract WP25: Calculate Probability in Each Pass of Stent-Retriever

• Published in: Stroke (1970) Vol. 49; no. Suppl_1
• Main Authors: Cardona, Pedro, Lara, Blanca, Quesada, Helena, De Miquel, Ma, Barranco, Roger, Aja, Lucia, Paipa, Andres, Chirife, Oscar, Rubio, Francisco, Mora, Paloma, Escrig, Ana
• Format: Journal Article
• Language: English
• Published: 22-01-2018
• ISSN: 0039-2499; 1524-4628
• DOI: 10.1161/str.49.suppl_1.WP25

Abstract only
Background:
Endovascular treatment with stent-retrievers has been approved and has demonstrated effective in treating strokes with large vessel occlusions. However number of passes through occluded artery and probability of recanalization in each artery could be an important technical and clinical topic.
Methods:
We performed an analysis of consecutives patients treated with stent-retriever from January 2011-May 2017. We analyze the number of passes to get recanalization (TICI 2b-3) according to occluded arteries. We assessed good functional outcome in Rankin scale (0-2) at 3 month, symptomatic intracranial hemorrhage (SICH) and mortality according to number of stent-retriever passes in each treated artery.
Results:
A total of 626 patients were analyzed, mean age 67+/-13, baseline NIH:17, OSTP (onset stroke time to groin puncture):268 min. Rankin 0-2 in 3month: 53%. Percentage of complete recanalization TICI 2-3 was 74% (43% after first pass of stent retriever, 65% in whom received a second pass, 76 % in third pass and 82% over four passes). Patients with few pass of stent retrievers (three passes) present a significant good functional outcome compared to patients treated with > 4 passes (61%vs19%), with same percentage SICH ( 7,4%vs8%). A variable associated to number of passes was OSTP. The percentage of successful recanalization (TICI 2b-3) with first-second pass of stent retriever were significantly different in TICA 54%, tandem 58%, basilar 56 % and 74% M1-M2 occlusions.
Conclusions:
Successful recanalization (TICI 2b-3) is highly probable till third pass of stent retriever. New devices could be tested in cases of failed recanalization after this third attempt.