Abstract Details

Title Acute Basilar Artery Occlusion Thrombectomy Performed in Early (6 hours) from the PC-SEARCH Registry

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) S24 - Cerebrovascular Disease and Interventional Neurology: Endovascular Thrombectomy and Large Vessel Occlusions (1:12 PM-1:24 PM)

Poster/Presentation
Number 002

Background Acute Basilar Artery Occlusion (BAO) results in high rate of morbidity and mortality. Recent randomized controlled trials from China demonstrated clinical benefit of mechanical thrombectomy.

Objective Evaluate the effect of early and late time window in a cohort of patients with BAO treated with thrombectomy.

Design/Methods PC-SEARCH is a large multi-centered retrospective registry of consecutive acute BAOs treated with thrombectomy with contributions from eight high-volume centers across the United States from July 2015 – December 2021. Patients were included in this registry if they received mechanical thrombectomy or intra-arterial thrombolysis within 24 hours of last seen normal. Registry includes data from baseline characteristics, pre- and intra- procedural data, radiographic and clinical outcomes. Good clinical outcomes were defined as mRS ≤ 3. Times were dichotomized into early (< 6 hours) and late (> 6 hours) time windows. Multivariate logical regression models were used to evaluate predictors of good outcome.

Results PC-SEARCH registry captured 519 patients, 479 with recorded outcomes at 90 days, Mean last-seen-normal to groin-puncture time was 132 min in the early time window and 765 min in the late time window patients; while NIHSS ( 17 vs 16, p 0.057), age (mean 65.8 vs 67.4, p 0.175), PC-ASPECTS (median 10 vs 9, p value 0.45), and door-groin puncture time (295 min vs 389 p 0.28) were not different between the two groups. Good recanalization (≥TICI 2b) was achieved in 82% of patients in the early time window and 81.5 % in the late time window (p 0.45). Rate of good outcome (45.8 vs 41.8, p value 0.41), sICH (7.1 vs 6.8 p 0.897) and mortality (40.3 vs 43.4 p 0.869) were similar between cohorts.

Conclusions In patients with acute basilar artery occlusion with excellent PC ASPECT score, similar rates of good clinical outcome can be achieved in the early and late time window.

Authors/Disclosures
Adam T. Mierzwa, MD (Promedica) PRESENTER	Dr. Mierzwa has nothing to disclose.
Nameer Aladamat, MBBS (The University of Toledo)	Dr. Aladamat has nothing to disclose.
Syed F. Zaidi, MD (ProMedica Stroke Network)	Dr. Zaidi has nothing to disclose.
Khaled Gharaibeh, MD (ProMedica Neurosciences Center)	Dr. Gharaibeh has nothing to disclose.
Ehad Afreen, MD (Promedica Physicians Group Neurology)	Dr. Afreen has nothing to disclose.
Sami Alkasab, MD (University of Iowa)	No disclosure on file
Ashley Nelson, DO (Medical University of South Carolina)	Dr. Nelson has nothing to disclose.
Mudassir Farooqui, MD	Dr. Farooqui has nothing to disclose.
Juan A. Vivanco-Suarez, MD	Mr. Vivanco-Suarez has nothing to disclose.
Ashutosh P. Jadhav, MD, FAAN (Barrow Neurological Institute)	Dr. Jadhav has nothing to disclose.
Shashvat Desai, MD (University of Pittsburgh Medical Center)	Dr. Desai has nothing to disclose.
Gabor Toth, MD (Cleveland Clinic Foundation)	Dr. Toth has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Dynamed. Dr. Toth has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Medtronic.
Anas M. Alrohimi, MD (University of Alberta)	Dr. Alrohimi has nothing to disclose.
Thanh Nguyen, MD	Dr. Nguyen has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Vesalio. Dr. Nguyen has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for NIH. Dr. Nguyen has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Avania. Dr. Nguyen has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for AHA. The institution of Dr. Nguyen has received research support from Boston Medical Center. The institution of Dr. Nguyen has received research support from Society of Vascular and Interventional Neurology.
Piers Klein	Mr. Klein has nothing to disclose.
Mohamad Abdalkader (Boston Medical Center Deptartment Of Radiology)	Mohamad Abdalkader has nothing to disclose.
	No disclosure on file
	No disclosure on file
Nirav Vora, MD	No disclosure on file
	No disclosure on file
Mouhammad A. Jumaa, MD (ProMedica Stroke Network)	Dr. Jumaa has nothing to disclose.
Santiago Ortega Gutierrez, MD (University of Iowa)	Dr. Ortega Gutierrez has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for stryker. Dr. Ortega Gutierrez has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for medtronic. Dr. Ortega Gutierrez has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for microvention. Dr. Ortega Gutierrez has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Medtronic. The institution of Dr. Ortega Gutierrez has received research support from stryker. The institution of Dr. Ortega Gutierrez has received research support from Medtronic. The institution of Dr. Ortega Gutierrez has received research support from Methinks. The institution of Dr. Ortega Gutierrez has received research support from NIH.