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Abstract Details

Impact of Deep Middle Cerebral Artery Infarcts on Stroke Thrombectomy Outcomes
Cerebrovascular Disease and Interventional Neurology
Cerebrovascular Disease and Interventional Neurology Posters (7:00 AM-5:00 PM)
036
To investigate whether pre-treatment infarct patterns can help predict thrombectomy outcomes.
Isolated deep MCA infarcts are thought to carry worse clinical outcomes as compared to mixed and cortical infarcts.
Review of a prospectively collected database of endovascular patients with anterior circulation Large vessel occlusion strokes between 1/2014 and 11/2018. Patients were categories into 5 groups according to stroke topology as assessed by NCCT e-ASPECTS: G1: cortical involvement only, G2 and G3: partial (1-2 regions) and complete (3+regions) deep gray matter respectively without cortical involvement, G4 and G5 partial (1-2 regions) and complete (3+regions) deep gray matter respectively with cortical involvement. Baseline characteristics and outcome measures were compared.

726 patients were analyzed: G1(n=36,5%), G2(n=385,38.1%), G3(n=76, 7.5%), G4(n=160,15.8%) and G5(n=69,6.8%). Baseline characteristics were comparable between groups except for increasing NIHSS and decreasing e-ASPECTS from G1 to G5(p=0.005 and <0.001 respectively).

Regarding outcomes, rates of good outcome (90-day mRS 0-2) were statistically different between groups (G1:45.7%, G2:49%, G3:52.6%, G4:38% and G5:32.4%,p=0.019) whereas there was no significant differences in rates any Parenchymal Hematomas(PH) (G1:11.1%, G2:9.6%, G3:14.5%, G4:13.1% and G5:21.7%,p=0.065)or 90-day mortality (G1:22.9%, G2:13.4%, G3:13.2%, G4:19% and G5:25%,p=0.068).

After adjusting for potential confounders on multivariate analysis, none of the groups were associated with any PH, good outcome or mortality (as compared to G1) except for a non-significant trend towards better functional outcomes in G3 (aOR 2.97, 95%CI[0.97-9.24],p=0.057). Furthermore, including topographic information did not improve the models as assessed by the Akaike Information Criterion. Sub-analysis limited ASPECT>5 yielded similar results.
Deep MCA strokes carry similar clinical outcomes as other stroke patterns. Future studies should evaluate the interactions between infarct volume and different topographies.
Authors/Disclosures
Mehdi Bouslama, MD (University at Buffalo Neurosurgery)
PRESENTER 		Dr. Bouslama has nothing to disclose.
No disclosure on file
No disclosure on file
Diogo C. Haussen, MD Dr. Haussen has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Stryker. Dr. Haussen has received stock or an ownership interest from Viz AI.
Michael R. Frankel, MD (Emory Univ School of Med/Dept of Neuro) The institution of Dr. Frankel has received research support from Nico Corporation, Inc.
Raul G. Nogueira, MD (UPMC Stroke Institute) Dr. Nogueira has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for for advisory roles with Anaconda, Biogen, Cerenovus, Genentech, Hybernia, Imperative Care, Medtronic, Phenox, Philips, Prolong Pharmaceuticals, Stryker Neurovascular, Shanghai Wallaby, and Synchron (consulting fees) as well as for advisory roles with Astrocyte, Brainomix, Cerebrotech, Ceretrieve, Corindus Vascular Robotics, Vesalio, Viz-AI, RapidPulse and Perfuze ( stock options). Dr. Nogueira has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for Law Firms. Dr. Nogueira has received stock or an ownership interest from Viz-AI, Perfuze, Cerebrotech, Reist/Q'Apel Medical, Truvic, and Viseon. The institution of Dr. Nogueira has received research support from Cerenovus.