Mechanical Thrombectomy in Acute Ischemic Stroke: a Regional Comprehensive Stroke Center Experience (P4.213)

Objective: We present a 5-year experience of stroke treatment by mechanical thrombectomy (MT) of the Comprehensive Stroke Center in Malopolska Voivodship in Poland, which serves for 11 stroke units and covers the population of 3,5 million inhabitants. Background: Mechanical thrombectomy utilizing new generation devices is an approved therapy of acute ischemic stroke due to emergent large vessels occlusion. Design/Methods: The Center fulfils recommendations for Comprehensive Stroke Centers ( Alberts MJ. Stroke 2005) and treatment is available 24/7. MT was preceded by rt-PAIV or, was not preceded, in those, who had a contraindication to IV thrombolysis or presented between 4.5–8 hours. The following data were collected: demographics, admission NIHSS, radiographic evaluation, time between stroke onset and groin puncture, rt-PAIV before MT, rt-PAIA during MT, concomitant emergency stenting of large artery, the type of stent retriever. Outcome measures: early (recanalization - TICI criteria; parenchymal hemorrhage - ECASS-1 classification); late: mRS at day 90. Results: 135 patients (mean age: 65,3 years) were included. 16% were moved from different cities. Mean admission NIHSS score was: 15.5±4,3. MT was preceded by rt-PAIV in 66% of patients. Acute thrombus location was as follows: ICA: 13,5%; MCA-M1: 54,8%; MCA-M2: 20,0%;MCA- M3: 3%, two locations: 5,8% and BA: 2,9%. Rt-PAIA was introduced in 4.5 % of cases, carotid stenting before the procedure was required in 7.7%. Mean time from stroke onset to groin puncture was 250,7±84,3 minutes. Solitaire device was used in 85,6% of cases. TICI 2ba/3 was found 63%. ECASS 1=0 was found in 52% of patients. 90-day RANKIN score was as follows: 0 – 70 (51.8%); 1 – 3 (2.2%); 2 – 4 (3%); 3 – 8 (5,9%); 4 – 7 (5.2%); 5 – 14 (10,4%); 6 – 29 (21,5%). Conclusions: We show similar safety and outcome measures of MT as recently published in the endovascular-treated arms of clinical trials and real-life clinical series. Disclosure: Dr. Slowik has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Boehringer Ingelheim, Bayer, Novartis, Sanofi, Pfizer, Biogen. Dr. Wloch-Kopec has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Neurofarma, UCB. Dr. Chrzanowska-Wasko has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Boehringer, Bayer, Biogen. Dr. Golenia has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Bayer, Boehringer Ingelheim, Biogen,. Dr. Ferens has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Boehringer Ingelheim, Bayer. Dr. Lasocha has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Microvention, Terumo, Penumbra, Medtronic. Dr. Serednicki has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Gambro, Frazenius, Molteni. Dr. Brzegowy has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Microvention, Terumo, Penumbra, Medtronic. Dr. Popiela has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Microvention, Terumo, Penumbra, Medtronic.