Abstract W P10: Endovascular Treatment for Anterior Circulation Stroke Leads to Similar Outcomes in Very Early (within 3 hours) versus Selected Late (Beyond 8 Hours) Presenting Patients
Background and Purpose: Endovascular therapy for acute ischemic stroke (AIS) is thought to have a higher chance of good outcome in patients presenting early than in those presenting late. However, a subgroup of late presenting patients, identifiable through advanced neuroimaging methods, has favorable physiology and can still experience good outcomes following reperfusion. We sought to compare outcomes in patients treated very early (within 3 hours) vs. late (beyond 8 hours) at our institution.
Methods: Via retrospective analysis of a prospectively collected database of 961 consecutive patients treated at our center (2001-2013), we identified patients with anterior circulation stroke who underwent endovascular treatment < 3 hours from time last seen well (with or without prior IV thrombolysis), and patients who underwent endovascular treatment > 8 hours from time last seen well, selected with advanced neuroimaging. Baseline characteristics and outcomes including MRI derived final infarct volumes (FIV) for each group were analyzed. [Table]
Results: We identified 108 patients treated < 3 hours and 177 patients treated > 8 hours from time last seen well. Baseline characteristics were not significantly different between the two groups except for differences in atrial fibrillation, baseline ASPECTS, and baseline NIHSS. All outcome measures were not significantly different between the two treatment groups. [Table]
Conclusion: Despite larger baseline infarcts in the > 8 hour group compared to the < 3 hour group, rates of good outcomes, FIV, and mortality did not differ between the two groups. These findings may be explained by differences in the rate of infarct growth from presentation to reperfusion in the two patient populations.
Author Disclosures: C. Streib: None. A. Aghaebrahim: None. S. Rangarauju: None. B. Jankowitz: None. E. Amorim: None. S. Paolini: None. M. Wintermark: None. G. Zhu: None. C. Leiva-Salinas: None. A. Jadhav: None. T. Jovin: Consultant/Advisory Board; Modest; Co-Axia, Concentric Medical, Micrus, ev3.
- © 2014 by American Heart Association, Inc.