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SNIS 20th annual meeting oral poster abstracts
P-005 Predictors for large vessel recanalization before stroke thrombectomy
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  1. H Chen1,
  2. M Colasurdo2,
  3. C Schrier3,
  4. M Khalid3,
  5. M Khunte4,
  6. T Miller3,
  7. J Cherian3,
  8. A Malhotra5,
  9. D Gandhi3
  1. 1National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
  2. 2Radiology, University of Maryland Medical Center, Baltimore, MD, USA
  3. 3University of Maryland Medical Center, Baltimore, MD, USA
  4. 4Warren Alpert Medical School of Brown University, Providence, RI, USA
  5. 5Yale New Haven Hospital, New Haven, CT, USA

Abstract

Background Large vessel recanalization (LVR) before endovascular therapy (EVT) for acute large vessel ischemic strokes is a poorly understood phenomenon, and better understanding of predictors for LVR is important for optimizing stroke triage and patient selection for bridging thrombolysis.

Methods In this retrospective cohort study, consecutive patients presenting to a comprehensive stroke center for EVT treatment were identified from 2018 to 2022. Demographic information, clinical characteristics, intravenous thrombolysis (IVT) use, and LVR before EVT were recorded. Factors independently associated with different rates of LVR were identified, and a prediction model for LVR was constructed.

Results 640 patients were identified. 57 (8.9%) patients had LVR before EVT. A minority (36.4%) of LVR patients had significant improvements in NIH stroke scale. Independent predictors for LVR were identified and used to construct the 8-point Recan score: IVT at least 1.5 hours before angiography (3 points), atrial fibrillation (1 point), hyperlipidemia (1 point), and site of vascular occlusion (internal carotid: 0 points, M1: 1 point, M2: 2 points, vertebral/basilar: 3 points). The Recan score had an area under the receiver operating curve (AUC) of 0.85 (95%CI 0.81 to 0.90; p<0.001) for predicting LVR. LVR before EVT occurred in only 1 of 302 patients (0.3%) with low (0-2) Recan scores.

Conclusions IVT at least 1.5 hours before angiography, site of vascular occlusion, atrial fibrillation, and hyperlipidemia are independent predictors for LVR. The 8-point Recan score proposed in this study may be a valuable tool for predicting LVR before EVT.

Abstract P-005 Figure 1
Abstract P-005 Figure 1

Disclosures H. Chen: None. M. Colasurdo: None. C. Schrier: None. M. Khalid: None. M. Khunte: None. T. Miller: None. J. Cherian: None. A. Malhotra: None. D. Gandhi: 1; C; National Institutes of Health, Focused Ultrasound Foundation, MicroVention, University of Calgary, University of Maryland Medical Center.

https://doi.org/10.1136/jnis-2023-SNIS.77

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