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Abstracts
Ischemic
2.3. Treatment
P115 Effectiveness and safety of mechanical thrombectomy in mild stroke: insights from the ASSIST registry
Free
  1. Sophia Hohenstatt1,
  2. Dominik Vollherbst1,
  3. Salvador Miralbés2,
  4. Bharath Naravetla3,4,
  5. Alejandro Spiotta5,
  6. Christian Loehr6,
  7. Mario Martinez Galdamez7,
  8. Ryan McTaggart8,
  9. Luc Defreyne9,
  10. Pedro Vega10,
  11. Osama Zaidat11,
  12. Paul Jerkins12,
  13. David Liebeskind13,
  14. Rishi Gupta14,
  15. Markus Moehlenbruch1,
  16. Agostino Tessitore15
  1. 1Neuroradiology, University Hospital Heidelberg, Heidelberg, Germany
  2. 2Neuroradiology, Hospital Son Espases, Mallorca, Spain
  3. 3Interventional Neuroradiology, McLaren Regional Medical Center, Flint, Michigain, USA
  4. 4Interventional Neuroradiology, McLaren Regional Medical Center, Macomb, Michigain, USA
  5. 5Neurosurgery, Medical University of South Carolina, Charleston, South Carolina, USA
  6. 6Radiology and Neuroradiology, Klinikum Vest Reckinghausen, Recklinghausen, Germany
  7. 7Interventional Neuroradiology/Endovascular Neurosurgery, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
  8. 8Interventional Neuroradiology, Rhode Island Hospital, Providence, Rhode Island, USA
  9. 9Vascular and Interventional Radiology, Ghent University Hospital, Ghent, Belgium
  10. 10Radiology, Hospital Universitario Central de Asturias-HUCA, Oviedo, Spain
  11. 11Neuroscience Department, Bon Secours Mercy Health St. Vincent Medical Center, Toledo, Ohio, USA
  12. 12Stryker Neurovascular, Fremont, California, USA
  13. 13Department of Neurology and Comprehensive Stroke Center, David Geffen School of Medicine, University of California, Los Angeles, California, USA
  14. 14Wellstar Medical Group, Neurosurgery, WellStar Health System, Marietta, Georgia, USA
  15. 15Neuroradiology, University Hospital G. Martino, Messina, Italy

Abstract

Introduction Mechanical thrombectomy (MT) is effective for acute ischemic stroke, yet its efficacy in mild stroke remains unclear.

Aim of Study This study evaluates MT’s effectiveness and safety in low NIHSS patients and assesses different MT strategies’ impact on procedural success and clinical outcomes.

Methods Data from the ASSIST Registry were analyzed, categorizing patients into mild (NIHSS≤5) and moderate-severe (NIHSS>5) stroke groups. Baseline characteristics, procedural parameters, angiographic and imaging outcomes, clinical outcomes, and safety endpoints were compared. Within the mild stroke subgroup, outcomes were compared between different MT techniques.

Results Among 1486 patients, 145 had minor ischemic stroke (10%). These had higher rates of excellent functional outcomes (mRS 0-1) at 90 days (80.2% vs. 44.4%, P<.0001) and greater functional independence (mRS 0–2) (86.4% vs. 55.7%, P<.0001) than moderate-severe stroke patients. Procedural success rates were similar between groups, while safety outcomes, except mortality, were comparable. No statistical differences were observed in treatment techniques within the mild stroke subgroup. A significant predictor of early neurological deterioration (END) in mild stroke patients was the total number of passes (OR 1.56, 95% CI 1.09–2.25, P=.018). Patients with END were more likely to have an unfavourable functional outcome (mRS 3-6) at 90 days (80% vs. 6%, P<0.0001).

Conclusion MT is effective and safe in mild stroke, with better outcomes than moderate-severe strokes. Procedural success did not vary among MT techniques in mild stroke. The total number of passes predicts END, which suggests a casual pathway that requires further exploration.

Disclosure of Interest no.

https://doi.org/10.1136/jnis-2024-ESMINT.151

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