Purpose The study attempts to identify notable factors predicting poor outcome, death and intracranial-haemorrhage in patients with acute ischaemic stroke undergoing mechanical thrombectomy with stent-retriever. This data could be useful to improve the selection of patients for thrombectomy.

Material and Methods Patients with acute ischaemic stroke treated with the Solitaire FR device were retrospectively analysed from a prospectively collected database. We assessed the effect of selected demographic characteristics, clinical and imaging factors on poor outcome at 3 months (modified Rankin score 3–6), mortality at 3 months and haemorrhage at day 1 (symptomatic and asymptomatic).

Results From May 2010 to April 2012, 59 consecutive patients with an acute ischaemic stroke underwent mechanical thrombectomy. At 3 months, 57.6% of the patients were functionally independent (mRS 0–2) and mortality was 20.4%. Multivariate analyses revealed that a thrombus length>14mm (p=0.02; OR 7.55; CI 95% 1.35-42.31) and longer endovascular procedure duration (p=0.01; OR 1.04; CI 95% 1.01-1.07) were independently associated with poor outcome. A higher baseline ASPECT score (p=0.04; OR 0.79 per point; CI 95% 0.63-0.99) and successful recanalisation (p=0.02; OR 0.07; CI 95% 0.01-0.72) were independent predictors of good functional outcome. Baseline ASPECT score (p<0.01; OR 0.65; CI 95% 0.54-0.78) independently predicted symptomatic intracranial haemorrhage at day1.

Conclusion A thrombus length >14mm is an independent predictor of poor functional outcome at 3 months after thrombectomy. Absolute baseline ASPECT score reflects early symptomatic haemorrhage risk and functional outcome at 3 months. Further analyses are needed to determine the importance of the thrombus length in the selection of patients for mechanical thrombectomy.

Disclosures L. Pierot: 2; C; Covidien/EV3. S. Soize: None. C. Barbe: None. K. HKadziolka: None. L. Estrade: None. I. Serre: None.