03:36 PM Abstract No. 164 Mechanical thrombectomy (MT) for anterior circulation emergent large vessel occlusions (ELVOs) performed by vascular interventional radiologists: single-center experience

Abstract

To report a single-center experience of the technical success and clinical 90-day outcomes of MT for anterior circulation ELVOs performed by interventional radiologists. A retrospective review identified 178 consecutive patients from January 2016 to March 2018 who underwent MT for anterior circulation ELVOs within 6 hours of symptom onset and initial NCCT ASPECTS ≥6, or presenting >6 hours but further selected with CT perfusion. Eight interventional radiologists performed the procedures. Technical and clinical outcomes were compared to the HERMES dataset. Eight patients were excluded for spontaneous revascularization. The average age was 66 years versus 68 years for HERMES. The average NIHSS was 17 for both groups. Vessel occlusions included: M1 59% (100/170) versus 69% (439/633), M2 12% (20/170) versus 8.0% (51/633), ICA 29% (50/170) versus 21% (133/633), and tandem ICA origin/M1 17% (29/170) (not reported in all trials), respectively. The overall mTICI 2b/3 reperfusion rate was 87% (148/170) versus 72% (405/633), respectively (p<0.05). The mRS 90-day outcome 0-2 rate was 40% (68/170) versus 46% (223/645), respectively (p=0.14). Major procedural complications were 3.5% (6/171) including 2 ICA dissections, 1 M2 MCA air embolization, 1 MCA wire perforation, 1 femoral hematoma requiring transfusion, and 1 anaphylaxis. Symptomatic intracranial hemorrhage rate was 4.1% (7/171) versus 4.4% (28/633), respectively. This single-center experience describes similar technical success and 90-day outcomes for MT of anterior ELVOs by interventional radiologists to the HERMES data set.