Abstract W MP2: Unchanged Utilization of Endovascular Treatment in Acute Ischemic Stroke Patients in the post IMS-III era

Abstract

Background: The results of Interventional Management of Stroke (IMS) III, MR RESCUE, and SYNTHESIS EXPANSION trials are expected to affect the utilization of endovascular treatment for acute ischemic stroke. Objective: To evaluate trends in utilization of endovascular treatment among acute ischemic stroke patients after the publication of IMS III, MR RESCUE, and SYNTHESIS EXPANSION trials. Methods: We obtained data for patients admitted to hospitals with a primary diagnosis of ischemic stroke using data from Minnesota Hospital Association. We determined the rate of utilization of endovascular treatment for acute ischemic stroke from March 2012 to December 2012 and March 2013 to December 2013. Outcomes were classified based on discharge disposition. Results: Of the 13,408 patients with ischemic stroke, 6765 (50.5%) were admitted with ischemic stroke prior to, and 6643 (49.5%) after the publication of trials’ results. The proportion of patients who underwent endovascular treatment was unchanged: 2.3% of ischemic stroke patients in the pre-IMS III group vs 2.4% in the post-IMS III group (p=0.6). The estimated number of patients undergoing any thrombolytic treatment increased (7.1% versus 7.8%,p=0.1). There was a significant reduction in length of stay in the post IMS III group, 3.8 ± 4.1 vs 3.6 ± 3.5 (p=0.02). The rates of discharge to home remained unchanged in the pre- and post- IMS III groups (3646 (53.9%) vs 3585 (54.0%), p=0.9). Conclusion: Contrary to expectations, there has been no reduction in the utilization of endovascular treatment among acute ischemic stroke patients after IMS-III, MR RESCUE and SYNTHESIS EXPANSION results were published.