Abstract TP81: Retrospective Gender Disparity Study Evaluating Arterial Size and Post Stroke Outcomes

Abstract

Introduction: Mechanical thrombectomy is now the standard of care for eligible large vessel occlusion (LVO) patients, but women are less likely to be independent at 90-days and have worse functional outcomes compared to men (Modified Rankin Scale (mRS) > 2). The factors that contribute to this disparity, including arterial size, have not been thoroughly explored and these factors are critical to understand for developing new thrombectomy technologies and techniques. Methods: Retrospective data from Barrow Neurological Institute was analyzed to determine the correlation between arterial diameters and the clinical outcome at 90-days of six patient groups (males vs. females: ages 18-40, 41-65, and 65+) after mechanical thrombectomy. Patients were adults who underwent aspiration thrombectomy for LVO within the past 3 years (verified with documented and calibrated computerized tomography (CT) and angiography) and had a documented 90-day mRS score. Vessel diameters were measured from calibrated patient CT scans and conventional angiograms. After adjusting for critical factors (such as demographics, pre-stroke mRS, and use of rTPA), a multiple logistic regression analysis was implemented to determine the correlation between arterial diameter and the 90-day clinical outcome. Results: The data suggests a correlation between arterial diameters and the efficacy of currently available thrombectomy systems. With cerebral vessel anatomical diameters documented as statistically smaller in women versus men, these results play a role in the worse outcomes seen in women. Conclusion: Currently available mechanical thrombectomy systems may not be optimized for patients with smaller arterial sizes as compared to patients with larger arterial sizes. Future devices with improved navigation and patient-specific size-adaptive capabilities may lead to improved patient outcomes.