E-156 Endovascular therapy for acute ischemic stroke: single community hospital experience

Abstract

Objectives The purpose of this study was to evaluate the efficacy of neurothrombectomy of stroke caused by large vessel occlusions (LVO) performed at our community hospital. We aimed to compare our results with those from the HERMES meta-analysis and STRATIS registry. Methods A retrospective analysis was performed on all eligible acute ischemic stroke patients who underwent endovascular treatment from January 1, 2015 to December 31, 2016. A total of 111 patients with acute stroke due to LVO treated with mechanical thrombectomy (MT) were included. The outcome was measured using the modified Rankin Scale (mRS) at 90 days. Efficacy was classified according to the modified thrombolysis in cerebral infarction (mTICI) scoring system. Safety was evaluated according to the incidence of procedural complications and symptomatic intracranial hemorrhage (sICH). Results Median age of patients (NCH vs HERMES vs STRATIS) was 75 versus 68 versus 68. The median National Institute of Health Stroke Scale (NIHSS) on hospital admission was 14 versus 17 versus 17, respectively. Intravenous thrombolysis was given to 30% versus 83% versus 64% of patients, respectively. Median time from groin puncture to reperfusion was 48 min versus 63 min versus 37 min, respectively. A modified Thrombolysis in Cerebral infarction score of 2b/3 was achieved in 87% (96/111) versus 71% (390/549) versus 88% (724/824), respectively. There was no statistically significant difference in the percentage of symptomatic intracranial hemorrhage and 90 day mortality. A modified Rankin Scale score of 0–2 at 3 months was achieved in 57% (63/110) versus 46% (291/633) versus 57% (512/906) of patients, respectively. Conclusions Data on efficacy, safety, and logistics of MT from our community hospital were similar to data from the HERMES collaboration and STRATIS registry. Our analysis confirms the applicability of neurothrombectomy in a real-world community hospital for stroke patients with large vessel occlusion. Disclosures M. Abuawad: None.