Abstract Details

Title Association Between Functional Outcomes of Stroke Patients Receiving Mechanical Thrombectomy and CT Perfusion Imaging Acquisition

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P8 - Poster Session 8 (8:00 AM-9:00 AM)

Poster/Presentation
Number 4-016

Objective Functional outcomes of Mechanical thrombectomy (MT) in stroke patients with CT perfusion (CTP+) imaging versus without (CTP–)

Background MT trials in the early window (<6hrs from last known normal (LKN)–SWIFT PRIME/EXTEND–IA) and extended window (6–24hrs from LKN–DAWN/DEFUSE–3) used perfusion imaging to select patients. Although these trials showed clinical benefit, there is limited data comparing functional outcomes among MT patients receiving CTP+ versus CTP–

Design/Methods We used data from 2 cohorts (New York University (NYU) and Blood Pressure After Endovascular Stroke Therapy (BEST)) and compared functional outcomes among sites that performed CTP for all patients versus those who did not. Good functional outcome was defined as a mRS of 0–2 at 90 days, or, if unavailable, a discharge mRS of 0–3. Binary logistic regression was used to predict the odds of good outcomes adjusting for age, NIHSS, recanalization grade, ASPECTS and LKN to reperfusion

Results There were 407 patients in the NYU (100 CTP+; 307 CTP–) and 135 patients in the BEST cohort (50 CTP+; 85 CTP–). Obtaining CTP was not associated with increased likelihood of good functional outcomes in NYU (adjusted OR (aOR) 1.41, 95%CI=0.53–3.76; p=0.49), BEST (aOR 1.28, 95%CI=0.27–6.17; p=0.76) and the pooled cohort (aOR 1.32, 95%CI=0.61–2.89; p=0.48) nor odds of symptomatic intracerebral hemorrhage in the pooled cohort (aOR 1.95, 95%CI=0.43–8.88; p=0.39). In addition, obtaining CTP was not associated with improved outcomes in the 6–24 hour window patients (n=295; aOR 1.69, 95%CI=0.42–4.53; p=0.61). Time from arrival to groin puncture was not significantly different between CTP+ and CTP– (72 min versus 82 min; p=0.17)

Conclusions In patients undergoing MT, CTP acquisition did not impact good functinal outcomes. Additionally, patients who received CTP had similar MT treatment times compared to those who did not receive it. Larger studies with set selection criteria are needed to determine how CTP acquisition affects clinical outcomes in MT patients

Authors/Disclosures
Shashank Agarwal, MD, MBBS (RWJBH Cooperman Barnabas Medical Center) PRESENTER	Dr. Agarwal has nothing to disclose.
Eva A. Mistry	No disclosure on file
	No disclosure on file
Sun Kim, MD	No disclosure on file
Matthew D. Sanger, MD	Dr. Sanger has nothing to disclose.
Kelley Humbert, MD (Penn Medicine)	Dr. Humbert has nothing to disclose.
Koto Ishida, MD, F�鶹��ýӳ�� (NYU)	Dr. Ishida has received publishing royalties from a publication relating to health care.
Jose L. Torres, MD (NYU)	Dr. Torres has nothing to disclose.
Sara K. Rostanski, MD (NYU School of Medicine)	Dr. Rostanski has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Individual law firms.
Cen Zhang, MD	Dr. Zhang has nothing to disclose.
Karthikeyan M. Arcot, MD (Interventional Neuro Associates)	No disclosure on file
David Turkel-Parrella, MD	No disclosure on file
	No disclosure on file
Eytan Raz	No disclosure on file
	No disclosure on file
Howard Riina	No disclosure on file
	No disclosure on file
	No disclosure on file
Erez Nossek	No disclosure on file
Peter Nelson, MD	No disclosure on file
Aaron Lord, MD (NYU Langone-Brooklyn)	Dr. Lord has nothing to disclose.
Denis Vezina, PhD (Hoechst-Marian Roussel)	No disclosure on file
Shadi Yaghi, MD (Hackensack Meridian Health)	Dr. Yaghi has nothing to disclose.

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