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P-034 First pass recanalization: incidence, predictors, and outcome
  1. M Anadani,
  2. A Alaweih,
  3. R Turner,
  4. M Chaudry,
  5. A Turk,
  6. A Spiotta
  1. Neurology, Medical University of South Carolina, Charleston, SC

Abstract

Introduction Recanalization with the first pass is known to improve mechanical thrombectomy outcome and lower complications rate. We report the outcome and predictors of first pass recanalization using ADAPT technique. First pass recanalization (FP) is defined as achieving successful recanalization (mTICI ≥2b) with first aspiration attempt.

Methods The A Direct Aspiration First Pass Technique (ADAPT) database was used to identify a subgroup of patients who achieved FP. Baseline characteristics, procedural, and postprocedural variables were collected. Outcome measures included 90 days modified Rankin scale (mRS), mortality and any hemorrhagic complications. Multivariate logistic regression was used to identify FP predictors.

Results A total of 524 patients were included of whom 178 achieved FP. More patients in the FP group received IV tPA (46.6% vs 37.6%; p<0.05). Procedure time was shorter in FP group (16.5±14.3 vs 34.2±24.5; p0.001). With respect to outcome, FP group had a better functional outcome (mRS 0–2; 53% vs 37%; p0.001), lower mortality rate (11.8% vs 24%; p<0.05) and lower incidence of hemorrhagic complications (29.2% vs 40.2%, p<0.05). Independent predictors of FP in the anterior circulation were IV tPA, non-tandem occlusion, and use of larger reperfusion catheter (ACE 64-ACE68, Penumbra Alameda, California, USA). Independent predictors of PF in the posterior circulation were lower baseline NIHSS and use of a larger reperfusion catheter.

Abstract P-034 Table 1

Comparison of baseline characteristics, procedural and outcome measures in patients depending on first pass success

Conclusion Recanalization with first aspiration pass associated with better functional outcome and lower mortality rate. IV tPA and use of larger aspiration catheters associated with FP.

Disclosures M. Anadani: None. A. Alaweih: None. R. Turner: 6; C; C; Codman Consulting, Honorarium, Speaker Bureau, Research Funding; Covidien Consulting, Honorarium, Speaker Bureau; Penumbra Consulting, Honorarium, Speaker Bureau, Research Grants; Microvention Cons. M. Chaudry: 6; C; C; Codman Consulting, Honorarium, Speaker Bureau, Research Funding; Covidien Consulting, Honorarium, Speaker Bureau; Penumbra Consulting, Honorarium, Speaker Bureau, Research Grants; Microvention Cons. A. Turk: 6; C; C; Codman Consulting, Honorarium, Speaker Bureau, Research Funding; Covidien Consulting, Honorarium, Speaker Bureau; Penumbra Consulting, Honorarium, Speaker Bureau, Research Grants; Microvention Con. A. Spiotta: 6; C; C; Penumbra Consulting, Honorarium, Speaker Bureau; Pulsar Vascular Consulting, Honorarium, Speaker Bureau; Microvention Consulting, Honorarium, Speaker Bureau, Research; Stryker Consulting, Honorari.

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