Abstract 138: The Interim Results Of The Multicenter Prospective Registry Of Acute Cerebral Large Vessel Occlusion In Japan: The Impact Of Rescue Endovascular Treatment For Intravenous Tissue Plasminogen Activator-failed Patients
Background: The multicenter prospective registry of Japan (RESCUE-Japan Registry) was performed to clarify the clinical impact of endovascular treatment (EVT) on acute cerebral large vessel occlusion.
Methods: Patients admitted within 24 h after stroke onsets were prospectively registered from July, 2010 to June, 2011. The efficacy of rescue EVT for intravenous intravenous tissue plasminogen activator (IV-tPA)-failed patients was analyzed.
Results: Among a total of 1,385 patients registered in this study, 940 patients (520 women, 420 men) with 3 months outcome were investigated as the interim analysis. Mean age was 74.5 years (range 22-99 years). The mean arrival time was 237.4 min after onset, and mean NIHSS was 15.6 points. The first treatment within 3 hours was IV-tPA in 51%, conservative therapy in 33%, EVT in 16%. In the patients treated with IV-tPA (n=148), significant recanalization (TICI 2B, 3 or modified Mori’s grade 3) was obtained in approximately 40% in M1 distal and M2 of MCA, but less than 20% in ICA 1-3 hours after IV-tPA. Rescue EVT after IV-tPA was performed in 72/285 patients (25.3%), which was significantly increased the previous study in 2008. Rescue EVT contributed significant recanalized the affected arteries (TICI 2B-3: 17% to 68%) (Fig.1) and increased the ratio of favorable outcome (modified Rankin scale:0-2) in ICA (0% vs 50%, p=0.037) (Fig. 2), and M1 proximal occlusion (33% vs 83%, p=0.033) (Fig.3).
Conclusions: The interim analysis of this nationwide registry suggested the efficacy of rescue EVT in IV-tPA failed patients with occlusion of the ICA and M1 proximal portion.
- © 2012 by American Heart Association, Inc.