Abstract W P27: Predictive Factors of Clinical Outcome and Hemorrhage after Acute Ischemic Stroke Treated by Mechanical Thrombectomy with Stent-retriever

Purpose: The study attempts to identify notable factors predicting poor outcome, death and intracranial-hemorrhage in patients with acute ischemic stroke undergoing mechanical thrombectomy with stent-retriever. Methods: Patients with acute ischemic stroke treated with the Solitaire FR device were retrospectively analyzed from a prospectively collected database. We assessed the effect of selected demographic characteristics, clinical and imaging factors on poor outcome at 3 months (modified Rankin score 3-6), mortality at 3 months and hemorrhage at day 1 (symptomatic and asymptomatic). Results: From May 2010 to April 2012, 59 consecutive patients with an acute ischemic stroke underwent mechanical thrombectomy. At 3 months, 57.6% of the patients were functionally independent (mRS 0-2) and mortality was 20.4%. Multivariate analyses revealed that a thrombus length>14mm (p=0.02; OR 7.55; CI 95% 1.35-42.31) and longer endovascular procedure duration (p=0.01; OR 1.04; CI 95% 1.01-1.07) were independently associated with poor outcome. A higher baseline ASPECT score (p=0.04; OR 0.79 per point; CI 95% 0.63-0.99) and successful recanalization (p=0.02; OR 0.07; CI 95% 0.01-0.72) were independent predictors of good functional outcome. Baseline ASPECT score (p<0.01; OR 0.65; CI 95% 0.54-0.78) independently predicted symptomatic intracranial hemorrhage at day1. Conclusions: Baseline ASPECT score reflects symptomatic hemorrhage risk and functional outcome at 3 months. Thrombus length measured on MRI play an important role on functional outcome at 3 months after thrombectomy. Further analyses are needed to determine its importance in the selection of patients for mechanical thrombectomy.