We present our five year endovascular acute ischemic stroke intervention results along with our clinical decision making process and institutional guidelines at a low volume academic medical center. We retrospectively reviewed our neurointerventional stroke database for the stroke interventions performed in the last 5 years at our institution, the only tertiary care academic medical center located at a rural setting in the northeast US serving a catchment area of more than a million population. We hypothesize that following the national guidelines and incorporating the evidence available in the current literature into clinical decision making, even at a relatively low volume referral center, clinical results on par with national standards can be achieved. We had a total of 1588 admissions for ischemic stroke between 06/2009 and 06/2014, 40 of which underwent endovascular intervention. We present our results and complications in comparison to national standards. Of the 40 patients elected for intervention, mean admission National Institutes of Health Stroke Scale was 15, 21 patients achieved adequate reperfusion (modified Thrombolysis in Cerebral Infarction Score greater than or equal to 2b) after intervention, perioperative complication rate was%7.5 (3 in 40 patients). Mean follow up was 12 months, mean modified Ranking Scale on discharge was 3 and on last follow up was 2. In conclusion, we present our experience at a rural academic setting as a real world test ground for the current guidelines and trends in endovascular stroke intervention.

Disclosures E. Akture: None. C. O'Neill: None. M. Gorman: None. C. Commichau: None. G. Linnell: None. D. Johnson: None.