Abstract WMP9: Comparative Analysis of Endovascular Treatment Outcomes in Acute Large Vessel Occlusion Strokes: Intracranial Atherosclerotic vs. Non- Intracranial Atherosclerotic Occlusions

Abstract

Introduction: Intracranial atherosclerotic disease (ICAD) is a common cause of ischemic stroke worldwide. We assessed the clinical outcomes of endovascular treatment in acute large vessel occlusion (LVO) strokes caused by ICAD and compared them with large vessel occlusion strokes not associated with intracranial atherosclerosis (non-ICAD LVO). Methods: Our study comprised 1390 adult patients diagnosed with LVO stroke that underwent endovascular therapy at Rhode Island Hospital from July 2015 to March 2023 and data collected retrospectively. Among these, 68 patients exhibited Intracranial Atherosclerotic Disease Large Vessel Occlusion (ICADLVO), while 1322 individuals were categorized as non-ICADLVO. In the ICADLVO group, 23 out of 68 patients underwent angioplasty, whereas 38 patients received stenting. We aim to compare treatment outcomes, including recurrent in-hospital large vessel occlusion, disability, and mortality between these two distinct groups, while also assessing demographic characteristics and medical risk factors. T-Test, Chi square and fisher’s exact tests were used for the comparison of groups. Results: The study findings highlight significant differences between the ICADLVO group and the non-ICADLVO group. The ICADLVO group had younger age (mean 66.6 ± 12.64 vs. 71.92 ± 14.56, p < 0.001) , higher proportion of individuals with Asian ethnicity (5.2% vs. 0.8%, p = 0.019), higher incidence of prior strokes (43.3% vs. 23.9%, p=0.000), higher prevalence of smokers (35.6% vs. 22.7%, p = 0.022), and a lower association with known atrial fibrillation (23.9% vs. 42.3%, p=0.003) compared to the non-ICADLVO group. Additionally, the ICADLVO group had a higher occurrence of recurrent large vessel occlusion during hospitalization (11.8% vs. 4%, p = 0.008). This analysis finds no significant difference in good 90-dayfunctional outcome (mRS <= 2) between the ICADLVO and NON-ICADLVO groups (OR = 0.62, 95% CI 0.34-1.13, p=0.118). Conclusion: Our study showed a higher incidence of recurrent large vessel occlusion during hospitalization in the ICADLVO group following endovascular therapy. However, we did not observe any statistically significant differences in long-term outcomes, including measures of disability and mortality.