DOI: 10.1161/str.55.suppl_1.wp215 ISSN: 0039-2499

Abstract WP215: Number of Passes Matter in Acute Ischemic Stroke Patients Who Underwent Failed Mechanical Thrombectomy

Sameh Samir Elawady, Conor Cunningham, Hidetoshi Matsukawa, Mohammad-Mahdi Sowlat, Kazutaka Uchida, Sara Zandpazandi, Atakan Orscelik, Ilko Maier, Sami Al Kasab, Pascal M Jabbour, Joon-Tae Kim, Stacey C Quintero, ansaar rai, Robert Starke, Marios Psychogios, Amir Shaban, Adam S Arthur, Shinichi Yoshimura, Hugo Cuellar, Brian Howard, Ali M Alawieh, Daniele G. Romano, Omar Tanweer, Justin Mascitelli, Isabel Fragata, Adam Polifka, Joshua Osbun, Roberto Crosa, Charles C Matouk, Min S Park, Michael Levitt, Waleed Brinjikji, Mark Moss, Travis Dumont, Richard Williamson, Pedro Navia, Peter Kan, Reade A De Leacy, Shakeel A Chowdhry, Mohamad Ezzeldin, Alejandro M Spiotta
  • Advanced and Specialized Nursing
  • Cardiology and Cardiovascular Medicine
  • Neurology (clinical)
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Introduction: Acute ischemic stroke (AIS) patients often require multiple passes during mechanical thrombectomy (MT) to open the vessel. Yet, at times, even numerous passes are unsuccessful. This study aims to investigate the impact of the number of passes on the outcomes of patients who underwent failed MT.

Methods: We used Data from the Stroke Thrombectomy and Aneurysm Registry (STAR) from 2013 to August 2023. Patients who underwent MT for ICA, M1, or M2 with unsuccessful recanalization (modified Thrombolysis in Cerebral Infarction ≤ 2a) were included. Primary outcome was 90- day modified Rankin Scale (mRS) 0-2. Secondary outcomes included any intracranial hemorrhage (ICH) and symptomatic ICH (sICH). Outcomes were compared among patients who received ≤ 2, 3, 4, and ≥ 5 MT passes.

Results: 736 patients met inclusion criteria. 90-day mRS 0-2 was found to decrease with number of passes (Figure 1). Multivariate logistic regression analysis revealed that 3 passes (OR: 0.48, 95% CI: 0.23 -0.96, P-value: 0.04), 4 passes (OR: 0.46, 95% CI: 0.19 -1.03, P-value: 0.07), and ≥ 5 passes (OR: 0.22, 95% CI: 0.08 -0.50, P-value: <0.001) were associated with lower odds of mRS 0-2 compared to ≤ 2 passes. However, there were no significant differences between groups in ICH, sICH, or 90-day mortality.

Conclusion: The number of passes affects functional outcomes among stroke patients who underwent failed MT.

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