ENDOVASCULAR MECHANICAL THROMBECTOMY WITHIN 6 TO 24 HOURS IN ELIGIBLE ACUTE ISCHEMIC STROKE PATIENTS – A REAL WORLD EXPERIENCE (ID 1212)
Abstract
Group Name
NEWONE RESEARCH GROUP
Background And Aims
Recent trials demonstrated the benefit of mechanical thrombectomy (MT) up to 24 hour in patients with target mismatch profile; however, outcomes in Vietnamese population remain poorly understood. Here, we evaluate the real-world outcomes of MT in anterior circulation stroke patients who were treated 6 to 24 hours after onset in Vietnam.
Methods
We conducted a prospective study of consecutive patients who underwent MT 6 to 24 hours after last seen well from June 2019 to May 2020 at 115 People’s Hospital, Vietnam. All patients had occlusion of internal carotid artery or proximal middle cerebral artery, and met the mismatch criteria of DAWN or DEFUSE-3 trial. Infarct volume and penumbral regions were measured by RAPID software. The primary outcome was functional independence (modified Rankin scale 0-2) at day 90. Safety outcomes were mortality rate and symptomatic intracranial hemorrhage (sICH).
Results
Of 120 enrolled patients, 69.2% met inclusion criteria of DEFUSE-3 trial, 73.3% met DAWN trial criteria. Mean age was 64.4±11.4 years, median baseline NIHSS was 15, median time from perfusion imaging to femoral puncture was 77 minutes, and median infarct volume was 9 mL. The rate of functional independence at 90 days was 49.2%. Successful recanalization (Thrombolysis in Cerebral Infarction score of 2b-3) was achieved by 89.2% of cases. The 90-day mortality rate was 14.2%, sICH was reported in 5 patients (4.2%).
Conclusions
Outcomes of extended window thrombectomy in eligible Vietnamese patients is comparable with the DEFUSE-3 and DAWN trial results. This study supports the practical use of endovascular therapy in these patients.
Trial Registration Number
N/A
