Abstract TP36: Impact of Intracranial Hemorrhage After Endovascular Treatment on Long-Term Functional Outcomes in Patients With Acute Large Vessel Occlusion: Insights From RESCUE- Japan Registry-2

Abstract

Background and Purpose: Endovascular therapy (EVT) for acute large vessel occlusion (LVO) is currently standard therapy, but it was associated with a higher incidence of intracranial hemorrhage (ICH) compared to conservative therapy. We investigated the impact of ICH within 72 hours on functional outcome at 90 days in patients with EVT for acute LVO. Methods: RESCUE-Japan Registry-2 was a multicenter registry enrolled 2420 consecutive patients with acute LVO within 24 hours of onset. We analyzed patients who received EVT and compared the functional outcomes between those with ICH (ICH group) and without ICH (No-ICH group) within 72 hours after onset. We estimated the adjusted odds ratio (OR) for good functional outcome as mRS 0-2 and mortality. We also explored the prognostic impact of symptomatic ICH (SICH) among those with ICH. Results: Among 2420 patients in the registry, 1281 received EVT and mean age was 75 years, and 759 (59.2%) were men. ICH occurred in 332 patients (25.9%). Good outcome was observed 80 patients (24.0%) and 454 patients (47.9%) in the ICH and No-ICH group, respectively, and the adjusted OR for good outcome of ICH group compared to No-ICH group was 0.30 (95% CI 0.22-0.42, p<0.0001). However, the mortalities within 90 days were not significantly different between groups (adjusted OR 1.13; 95% CI 0.72-1.76, p=0.59). SICH was observed in 35 patients (10.5%) among 332 patients with ICH, and the good outcomes were 8.6% and 25.9 % in patients with SICH and asymptomatic ICH (AICH), respectively (p=0.02). Mortality at 90 days were 31.4% and 7.0% in patients with SICH and AICH, respectively (p<0.0001). Conclusion: The functional outcomes at 90 days after onset was significantly worse in patients suffered ICH than the counterparts after EVT for acute LVO. However, the mortality rates were generally similar between those with and without ICH. Among patients with ICH, mortality was higher in patients with SICH, but mortality of the patients with AICH was similar to those without ICH.