Abstract T P15: Final Infarct Volume as Predictor of Clinical Outcomes Following Intra-Arterial Stroke Treatment

Abstract

OBJECTIVE: Previous studies have shown age and recanalization as principal variables influencing clinical outcome following intra-arterial stroke treatment (IAT). We sought to study the impact of final DWI infarct volume on patient outcomes following IAT. METHODS: We reviewed records of stroke patients who underwent IAT at our center from Jul 2012 – Jul 2014. Patients demographics, risk factors, admission clinical and neuroimaging findings, treatment times and methods, procedure related complications and modified Rankin score (mRS) at 90 days were analyzed. For patients who are not yet at 90 days post-treatment, mRS at hospital discharge was used in the final analysis. A favorable outcome was defined as mRS 2 or less at 90 days. Infarct volume was calculated using the MIM Maestro automated software on post IAT MR DWI sequences. RESULTS: Overall, 144 consecutively treated patients were identified. Eighty-eight subjects underwent post treatment MRI and are included in this analysis. Patients who achieved successful recanalization (TICI 2b &3) had lower mean infarct burden (53.2 mL) than the cohort with persistent occlusion (95.1 mL), p=0.01. Also, patients with favorable outcomes had significantly lower mean infarct volumes (see table). Multivariate logistic regression model identified lower final DWI infarct volume (OR 0.97, 95% CI 0.95-0.99, p<0.01) and low presentation NIHSS (OR 0.85, 95% CI 0.73-0.99, p=0.04) as predictors of favorable outcome. CONCLUSION: Our study results indicate that final DWI infarct volume is an independent predictor of outcome in patients undergoing IAT. Infarct volume may be utilized as a surrogate for clinical outcome. Larger prospective studies are warranted to corroborate these findings.