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O-003 IMS3 Like Subgroup Analysis in the North American SOLITAIRE Stent-Retriever Acute Stroke Registry
  1. R Nogueira1,
  2. A Castonguay2,
  3. R Gupta1,
  4. C Sun1,
  5. C Martin3,
  6. W Holloway3,
  7. N Mueller-Kronast4,
  8. J English5,
  9. I Linfante6,
  10. G Dabus7,
  11. T Malisch8,
  12. H Bozorgchami9,
  13. A Xavier10,
  14. A Rai11,
  15. M Froehler12,
  16. A Badruddin13,
  17. T Nguyen14,
  18. M Taqi15,
  19. M Abraham16,
  20. V Janardhan17,
  21. H Shaltoni18,
  22. A Yoo19,
  23. A Abou-Chebl20,
  24. P Chen21,
  25. O Zaidat2
  1. 1Emory University School of Medicine, Atlanta, GA
  2. 2Medical College of Wisconsin, Milwaukee, WI
  3. 3St. Luke’s Kansas City, Kansas City, MO
  4. 4Delray Medical Center, Delray Beach, FL
  5. 5California Pacific Medical Center, San Francisco, CA
  6. 6Baptist Cardiac and Vascular Institute, Miami, FL
  7. 7Baptist Cardiac and Vascular Institute, Miami, CA
  8. 8Alexian Brothers Medical Center, Elk Grove Village, IL
  9. 9Oregon Health and Sciences, Portland, OR
  10. 10Wayne State University School of Medicine, Detroit, MI
  11. 11West Virginia University Hospital, Morgantown, WV
  12. 12University of Iowa, Iowa City, IA
  13. 13Provena St. Joseph Medical Center, Joliet, IL
  14. 14Boston Medical Center, Boston, MA
  15. 15Desert Regional Medical Center, Palm Springs, CA
  16. 16University of Kansas Medical Center, Kansas City, KS
  17. 17Texas Stroke Institute, Plano, TX
  18. 18Baylor College of Medicine, Houston, TX
  19. 19Massachusetts General Hospital, Boston, MA
  20. 20University of Louisville Medical School, Louisville, KY
  21. 21The University of Texas Medical School at Houston, Houston, TX

Abstract

Introduction/Purpose IMS3 demonstrated no significant difference between treatment with IV-rtPA alone or IV-rtPA plus IA therapy. However, the trial included only earlier generations of thrombectomy devices and did not evaluate the efficacy of newer devices. Here, we present data on an “IMS-III-Like group” from The North American SOLITAIRE Acute Stroke (NASA) Registry, a repository database of the newer generation Solitaire Stent-retriever. An exploratory analysis was performed to compare these results to the IMS3 IV and IV/IA groups.

Materials and Methods The investigator-initiated NASA Registry recruited sites to submit data on consecutive patients treated with Solitaire-FR. A cohort similar to the IMS-III IV-rtPA+Solitaire-FR population (NASA-IMS3 Matched Group (NIMG)) was identified and compared to the recently published results of the IMS3 IV and IV/IA groups. Good clinical outcome was defined as a 90-day mRS ≤2. Successful recanalisation was defined as TIMI ≥2. SICH was defined as any parenchymal haematoma, SAH, or IVH associated with a worsening of the NIHSS score by 4 or more within 24 hours.

Results 354 acute ischaemic stroke patients were enrolled in the NASA Registry from 24 centres. The cohorts were comprised of: 156 NIMG versus 434 and 222 in the IMS3 IV/IA and IV only groups, respectively. Baseline demographics were similar between cohorts: Median age 70 (NIMG); 69 (IMS3 IV/IA); 70 (IMS3 IV). Initial median NIHSS was higher in NIMG (19) compared to the IMS3 IV/IA (17) and IMS3 IV groups (18). mTICI > 2b rate was 69.9% in NIMG versus 39.6% in the IMS III IV/IA. Interestingly, mTICI 3 rate was 41% in NIMG vs 2.2% in the IMS III IV/IA group.

The 90-day mRS outcome was available in 88.5% (138/156) of NIMG patients. A good outcome of mRS?2 was demonstrated in 51.5% (71/138), compared to 40.8% (169/415) in IMS3 IV/IA and 38.7% (83/215) in IM3 IV alone groups. 90-day mortality was 24.6% in NIMG versus 19.1% and 21.6% in IMS3 IV/IA and IV alone groups, respectively.

View this table:
Abstract O-003 Table 1

Conclusion In the NASA registry, the NASA-IMS3 Matched Group (NIMG) demonstrated a higher rate of good clinical outcome (51.5%) compared to the IMS3 IV/IA (40.8%) and IV alone (34.6%) groups.

Disclosures R. Nogueira: None. A. Castonguay: None. R. Gupta: None. C. Sun: None. C. Martin: None. W. Holloway: None. N. Mueller-Kronast: None. J. English: None. I. Linfante: None. G. Dabus: None. T. Malisch: None. H. Bozorgchami: None. A. Xavier: None. A. Rai: None. M. Froehler: None. A. Badruddin: None. T. Nguyen: None. M. Taqi: None. M. Abraham: None. V. Janardhan: None. H. Shaltoni: None. A. Yoo: None. A. Abou-Chebl: None. P. Chen: None. O. Zaidat: None.

https://doi.org/10.1136/neurintsurg-2013-010870.3

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