Abstract TP3: Endovascular Thrombectomy Improves Long-Term Outcomes of Acute Ischemic Stroke Patients: A Real World Observational Study

Abstract

Introduction: Recently, REVASCAT and MR CLEAN studies reported favorable long-term outcome of acute ischemic stroke (AIS) patients at 1 and 2 years post endovascular thrombectomy (ET) respectively. However, no study in the real world has reported long-term outcomes of AIS after ET. Chinese patients largely experience AIS due to large artery atherosclerosis (LAA), and approximately half of them have intracranial artery stenosis. The differences of AIS patients of LAA and cardioembolism and treated with ET are unclear. In this study, we evaluate the long-term outcomes of AIS patients after ET in the real world, and investigate differences between AIS patients of different etiology. Methods: This observational study based on a prospective registry study of revascularization therapy for AIS. Favorable outcome was defined as modified Ranks scale (mRS) scores 0-2, and unfavorable outcome was defined as mRS scores 3-6. The primary outcome was mRS at the time of assessment. Results: Eighty nine subjects (aged 59.5 years old) with large artery occlusion in anterior circulation and treated with ET were recruited. Median length of follow up was 20 months (IQR 6-32), including 74% subjects longer than 12 months and 43% subjects longer than 24 months. At the time of follow up, 47 subjects (53%) achieved favorable outcome whereas 17 subjects (19%) were functional dependence and 25 subjects (28%) died. More subjects of LAA were treated with permanent intracranial stenting (22% vs. 10%) as compared with those of cardioembolism. Subjects of cardioembolism are more likely to experience sICH (19% vs. 8%) and die (32% vs. 16%) as compared with those of LAA. During the study period, 3 subjects (3.4%) had post-stroke seizures, and the incidences of recurrent stroke were 1% after 3 months, 3% after 6 months, 7% after 12 months, and 8% after 42 months Conclusions: Over half of AIS patients can achieve favorable long-term outcomes after ET. Subjects of cardioembolism are more likely to experience sICH and die.