First Pass Rates Differ Between Anterior Circulation And Vertebrobasilar Occlusions During Mechanical Thrombectomy For Emergent Large Vessel Occlusions

Objective: To compare the first pass effect (FPE) rates of existing mechanical devices between anterior circulation and vertebrobasilar occlusion and their clinical outcomes from a pooled data of two institutions. Background: There is limited data regarding the effectiveness of mechanical thrombectomy and thrombectomy devices to achieve recanalization in veretebrobasilar occlusion. FPE is defined as achieving a TICI 3 recanalization with a single device pass with no use of rescue therapy. Design/Methods: Patients were identified from 2 prospectively collected stroke databases from Jan 2015 to March 2018. We compared the FPE rates between anterior circulation and vertebrobasilar occlusions. Other clinical outcomes were favorable functional outcome at hospital discharge (modified Rankin Scale (mRS) score of 0–3), and the rate of intracranial hemorrhage (ICH). Results: A total of 245 patients who underwent thrombectomy were identified. FPE was achieved in total of 97 (39.5 %)patients [mean age 68.8 ± 14.1 years, 51 (52.6%) were women]. Overall, 79 (37.2%) of anterior circulation patients had FPE versus 18 (54.5% ) with vertebrobasilar occlusions ( p-value Conclusions: In this analysis, vertebrobasilar occlusions had significantly higher percentage of FPE with current thrombectomy devices compared to anterior circulation occlusions. However, both groups with FPE have similar good functional outcomes and ICH rates. Disclosure: Dr. Daniel has nothing to disclose. Dr. Memon has nothing to disclose. Dr. Grewal has nothing to disclose. Dr. Olan has nothing to disclose. Dr. Sigounas has nothing to disclose. Dr. Putman has nothing to disclose. Dr. Greenberg has nothing to disclose.