Abstract 168: Prospective Nationwide Registry of Acute Stroke due to Large Vessel Occlusion in Japan
Background: The multicenter prospective registry of Japan (RESCUE-Japan Registry) was performed to clarify the clinical impact of endovascular treatment (EVT) on acute stroke due to large vessel occlusion.
Methods: Patients admitted within 24 h after onset 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 1,454 patients registered from 84 medical centers, 1,442 patients (633 women, 899 men) with 3 months outcome were analyzed. Mean age was 74.0 years, and mean arrival time was 233.4 min after onset, and mean NIHSS was 15.5 points. As the revascularization treatment within 3 h, IV-tPA was performed in 51%, EVT in 16% and their combination in 17%. In the patients treated with IV-tPA (n=194), significant recanalization (TICI 2B and 3) was obtained in 29-39% in MCA, but less than 15% in ICA on cerebral angiogram performed 1 to 3 h after IV-tPA (Fig1). Rescue EVT after IV-tPA was performed in 129 patients (17%), and increased significant recanalization (17% to 68%) (Fig.2) and favorable outcome (mRS:0-2) in the ICA (22% vs 48%, p=0.007) (Fig. 3), but not symptomatic intracranial hemorrhage (6.1% vs 4.1%) (p=0.35).
Conclusions: This registry suggested the efficacy of rescue EVT in IV-tPA failed patients, especially with ICA occlusion.
- © 2012 by American Heart Association, Inc.