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P-002 Mechanical thrombectomy for patients with stroke presenting with low alberta stroke program early computed tomography score (ASPECTS): early versus late time window outcomes
  1. S Samir Elawady1,
  2. M Mahdi Sowlat1,
  3. I Maier2,
  4. P Jabbour3,
  5. J Kim4,
  6. S Quintero Wolfe5,
  7. A Rai6,
  8. RM Starke7,
  9. M Psychogios8,
  10. E Samaniego9,
  11. A Arthur10,
  12. S Yoshimura11,
  13. JA Grossberg12,
  14. A Alawieh12,
  15. J Mascitelli13,
  16. I Fragata14,
  17. H Cuellar15,
  18. A Polifka16,
  19. J Osbun17,
  20. R Crosa18,
  21. C Matouk19,
  22. MS Park20,
  23. MR Levitt21,
  24. W Brinjikji22,
  25. T Dumont23,
  26. R Williamson24,
  27. P Navia25,
  28. AM Spiotta1,
  29. S Al Kasab1
  1. 1Division of Neuroendovascular Surgery, Department of Neurosurgery, Medical University of South Carolina, Charleston, SC, USA
  2. 2Universitätsmedizin Göttingen, Göttingen, Germany
  3. 3Thomas Jefferson University, Philadelphia, PA, USA
  4. 4Chonnam National University Hospital, Gwangju, Korea, Republic of
  5. 5Wake Forest Baptist Health, Winston-Salem, NC, USA
  6. 6West Virginia University, Morgantown, WV, USA
  7. 7University of Miami Health System, Miami, FL, USA
  8. 8Universitätsspital Basel, Basel, Switzerland
  9. 9University of Iowa, Iowa City, IA, USA
  10. 10University of Tennessee Health Science Center/Semmes Murphey Foundation, Memphis, TN, USA
  11. 11Hyogo College of Medicine, Hyogo, Japan
  12. 12Emory University, Atlanta, GA, USA
  13. 13University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
  14. 14Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal
  15. 15LSU Health Shreveport, Shreveport, LA, USA
  16. 16University of Florida, Gainesville, FL, USA
  17. 17Washington University in St. Louis, St. Louis, WA, USA
  18. 18Médica Uruguaya, Departamento de Montevideo, Uruguay
  19. 19Yale University, New Haven, CT, USA
  20. 20University of Virginia, Charlottesville, SC, USA
  21. 21University of Virginia, Seattle, WA, USA
  22. 22Mayo Clinic, Rochester, MN, USA
  23. 23University of Arizona, Tucson, AZ, USA
  24. 24Alleghany Hospital, Sparta, NC, USA
  25. 25Hospital Universitario La Paz, Madrid, Spain


Background and Purpose Recent trials showed a clear benefit of mechanical thrombectomy for patients with emergent large vessel occlusion and large core infarction. However, limited number of patients were included in the late window. This study aimed to compare outcomes of low ASPECTS stroke patients who underwent mechanical thrombectomy in the early versus late time window.

Methods A retrospective cohort study was conducted using data from the Stroke Thrombectomy and Aneurysm Registry (STAR) from 2013 to 2023. Patients with low ASPECTS (2-5) who underwent mechanical thrombectomy for ICA or M1 stroke were included. Patients were divided into early (within 6 hours) and late (6-24 hours) time window groups. The primary outcome was 90-day favorable outcome (modified Rankin Scale [mRS] score 0-3).

Results Among the 10,081 patients who underwent mechanical thrombectomy, 387 met the inclusion criteria. Of those, 219 (56.6%) were treated in the early window. Median (IQR) age was 70.4 (60-78) years, 180 (46.5%) were female, and 221 (68.4%) were White. There was no significant difference in successful recanalization rates (Thrombolysis in Cerebral Infarction [TICI] 2C/3) between the early and late window groups (56.6% versus 52.4%, P=0.478). Additionally, there was no significant difference in favorable outcomes at 90 days between the two groups (25.4% versus 35.9%, P=0.142). In Binary regression analysis, age (OR 0.94; 95% CI 0.92-0.97; P<0.001), admission NIHSS (OR 0.88; 95% CI 0.83-0.94; P<0.001), and successful recanalization (OR 4.01; 95% CI 1.94-8.71; P<0.001) were predictors of a favorable outcome at 90 days.

Conclusion Mechanical thrombectomy appears to carry a similar benefit profile among patients treated in the late window as those in the early window.

Disclosures S. Samir Elawady: None. M. Mahdi Sowlat: None. I. Maier: None. P. Jabbour: None. J. Kim: None. S. Quintero Wolfe: None. A. Rai: None. R. M Starke: None. M. Psychogios: None. E. Samaniego: None. A. Arthur: None. S. Yoshimura: None. J. A. Grossberg: None. A. Alawieh: None. J. Mascitelli: None. I. Fragata: None. H. Cuellar: None. A. Polifka: None. J. Osbun: None. R. Crosa: None. C. Matouk: None. M. S. Park: None. M. R. Levitt: None. W. Brinjikji: None. T. Dumont: None. R. Williamson Jr: None. P. Navia: None. A. M Spiotta: None. S. Al Kasab: None.

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