Abstract 202: Endovascular Therapy for Acute Ischemic Stroke With Distal Large Vessel Occlusion in the Anterior Circulation

• Published in: Stroke (1970) 2016-02, Vol.47 (suppl_1)
• Main Authors: Sarraj, Amrou, Sangha, Navdeep, Hussain, Muhammad Shazam, Wisco, Dolora, Vora, Nirav, Elijovich, Lucas, Goyal, Nitin, Abraham, Michael, Mittal, Manoj, Feng, Lei, Wu, Abel, Janrdan, Vallabh, Nalluri, Suman, Yoo, Albert, George, Megan, Edgell, Randall, Shah, Rutvij J, Sitton, Clark, Supsupin, Emilio, Bajgur, Suhas, Denny, M. Carter, Chen, Peng R, Dannenbaum, Mark, Martin-Schild, Sheryl, Savitz, Sean I, Gupta, Rishi
• Format: Article
• Language: English
• ISSN: 0039-2499; 1524-4628
• DOI: 10.1161/str.47.suppl_1.202

Abstract only Introduction: Five RCTs demonstrated the superiority of endovascular therapy (EVT) over best medical management (MM) for acute ischemic strokes (AIS) with large vessel occlusion (LVO) in the anterior circulation. Patients with M2 occlusions, however, were underrepresented (95 randomized; 51 EVT treated). Evidence from RCTs of the benefit of EVT for M2 occlusions is lacking, as reflected in the recent AHA guidelines. Methods: A retrospective cohort was pooled from 10 academic centers from 1/12 to 4/15 of AIS patients with LVO isolated to M2 presenting within 8 hours from last known normal (LKN). Patients were divided into EVT and MM groups. Primary outcome was 90 day mRS (good outcome 0-2); secondary outcome was sICH. Logistic regression compared the 2 groups. Univariate and multivariate analyses evaluated predictors of good outcome in the EVT group. Results: Figure 1 shows participating centers, 522 patients (288 EVT and 234 MM) were identified. Table (1) shows baseline characteristics. MM treated patients were older and had higher IV tPA treatment rates, otherwise the 2 groups were balanced. 62.7 % EVT patients had mRS 0-2 at 90 days compared to 35.4 % MM (figure 2). EVT patients had 3 times the odds of good outcome as compared to MM patients (OR: 3.1, 95% CI:2.1-4.4, P