P169/277 Underlying intracranial atherosclerotic disease is associated with worse outcomes in acute large vessel occlusion undergoing endovascular thrombectomy

Introduction

Data on large vessel occlusion (LVO) management due to underlying intracranial atherosclerotic disease (ICAD) is scarce. We hypothesized that patients with ICAD have worse clinical outcomes following mechanical thrombectomy (MT) than those without ICAD.

Aim of Study

To investigate outcomes in patients with ICAD who underwent MT

Methods

We performed a retrospective analysis of patients who underwent MT for LVO. We compared in-hospital and 90-day mortality, and 90-day modified Rankin Scale (mRS) scores between those with and without ICAD, in unadjusted and adjusting logistic regression models.

Results

Among 215 patients (mean age 67.1±16.0 years; 60.5% female; 80.5% Black, median NIHSS score 16), ICAD was present in 38 patients (17.7%). Diabetes and dyslipidemia were more common in those with ICAD (57.9% vs. 38.4%, p=0.027 and 29.0% vs. 14.7%, p=0.035, respectively). Substantial reperfusion (TICI ≥2b) was achieved less often (84.2% vs. 94.4%, p=0.031) but symptomatic ICH was also less common in ICAD patients (0% vs. 9.0%, p=0.054). In-hospital and 90-day mortality were more common (36.8% vs. 15.8%, p=0.003 and 52.6% vs. 26.6%, p=0.002, respectively) and favorable functional outcome (mRS 0–2) at 90 days was less common (7.9% vs. 33.9%, p=0.001) in ICAD patients. ICAD was independently associated with in-hospital mortality (OR=4.1, 95% CI 1.7–9.7), 90-day mortality (OR=3.7, 95% CI 1.6–8.6), and poor functional outcome at 90 days (OR=5.5, 95% CI 1.6–19.4).

Conclusion

Symptomatic ICAD in a predominantly African American cohort is associated with increased odds of mortality and poor functional outcome at 90 days in patients with LVO undergoing MT.

Disclosure of Interest

The authors have nothing to disclose.