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  • Rate of Reocclusion and Recurrent Stroke After Mechanical Thrombectomy

    Final Number:
    205

    Authors:
    Muaz Qayyum; Ameet V. Chitale MD; Badih Daou MD; Daniel Benito; Pascal Jabbour MD; Robert H. Rosenwasser MD, FACS, FAHA; Stavropoula I. Tjoumakaris MD

    Study Design:
    Other

    Subject Category:
    Ischemic Stroke

    Meeting: AANS/CNS Cerebrovascular Section 2016 Annual Meeting

    Introduction: BACKGROUND: Mechanical thrombectomy has become a widely utilized tool for the management of acute ischemic stroke allowing for an increase in the therapeutic window, increased rates of vessel recanalization and significant improvement in clinical outcome. The rates of of vessel reocclusion and recurrent stroke following mechanical thrombectomy remain unknown in stroke patients.

    Methods: METHODS: Two hundred and forty five patients who presented with acute ischemic stroke and further treated for stroke with mechanical thrombectomy (Solitaire/Pneumbra/Trevo/Merci) were identified retrospectively. Baseline patient characteristics and imaging data were recorded. Modified Rankin scale (MRS) score at the latest follow-up was determined along with determination of the rate of reoclussion and recurrent stroke.

    Results: RESULTS: Mean patient age was 64.4 years. 50.9% of patients received tPA prior to mechanical thrombectomy. Mean NIHSS score on arrival was found to be 15.73. Mean follow-up duration was 148 days. Vessel reocclusion rate was found to be 6.9% (17/245) patients. The rate of recurrent stroke after thrombectomy was 11.02% (27/245). 8 patients (3.3%) had recurrent stroke in the same vascular territory. 19 patients (7.75%) had embolic stroke following intervention. (LICA=9.7%, LM1=9.7%, LM2=9.7%, RICA=21.95%, RM1=34.1%, RM2=4.8%, VA=2.44%, BA=2.44%, LA2=4.88%, RA2=4.88%) Mean time from initial stroke to recurrent stroke was 14.8 days. Mean MRS at the latest follow-up was 2.

    Conclusions: CONCLUSION: The rate of recurrent vascular reocclusion and recurrent stroke following mechanical thrombectomy is low and occurs early following the intervention.

    Patient Care: Mechanical thrombectomy has become a widely utilized tool for the management of acute ischemic stroke. We conducted this study in order see the clinical outcome/complications after mechanical thrombectomy. By this study's conclusion we can get a fair amount of idea whether or not there is need to develop another/new mode of treatment for acute ischemic strokes in addition to mechanical thrombectomy if patients suffer lot of complications post-operatively (mechanical thrombectomy) including high rate of stroke recurrence.

    Learning Objectives: OBJECTIVE: To determine the rate of reocclusion and recurrent stroke in patients after treatment of acute ischemic stroke with mechanical thrombectomy .

    References:

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