Abstract TP134: The Effect Of Aortic Arch And Carotid Artery Anatomy Parameters On Door-To-Recanalization Times At A Comprehensive Stroke Center

Abstract

Introduction: The American Heart Association recommends a Door-to-Recanalization/Reperfusion (DTRp) time of ≤120 minutes. We aim to identify aortic arch and carotid artery anatomy parameters associated with a delayed DTRp at a comprehensive stroke center (CSS). Methods: We performed a retrospective chart review of patients who underwent mechanical thrombectomy (MT) for an anterior circulation large vessel occlusion (LVO) at a CSS from 1/2015 to 12/2021. We compared various aortic arch and carotid artery anatomy parameters between patients who achieved DTRp in ≤120 minutes vs.>120 minutes. A blinded board-certified neuroradiologist used the pre-MT CT Angiogram to document different aortic arch and carotid artery anatomy variables. A binary logistic regression analysis was performed, controlling for age, gender, presenting mean arterial pressure (MAP), presenting serum glucose, Hb A1C, LDL, intravenous alteplase, left hemispheric location, location of occlusion [proximal (ICA or M1 segment of the middle cerebral artery) versus distal (M2 segment of the middle cerebral artery)], ASPECTS≥6, general anesthesia, transradial approach, number of passes. Results: 256 patients met our inclusion criteria. The mean age was 65.18±14.89 years. In our cohort, the presence of a bovine arch was significantly associated with a DTRp of >120 minutes (39.19% vs. 20.59%; OR, 0.37; 95 % CI, 0.15-0.94; P 0.035). Whereas, the other aortic arch and carotid artery anatomy parameters were not significantly associated with DTRp of >120 minutes, as shown in the Table. Conclusion: Among aortic arch and carotid artery anatomy parameters, the presence of a bovine arch was associated with significantly delayed DTRp of >120 minutes in our cohort.