E-141 Large vessel occlusion stroke thrombectomy in the elderly: is 90 the new 80?

M Bouslama, G Rodrigues, L Pisani, D Haussen, M Frankel, R Nogueira
2019 Electronic poster abstracts   unpublished
angioplasty. 4 patients had carotid stenting. The decision on emergent stenting was based on the algorithm shown in Image attachment. Stenting is done following Bolus GP2B3A inhibitor followed by infusion for 6 hours and Asprin and Plavix given through NG tube. Successful recanalization based on thrombolysis in cerebral infarction (TICI) score of 2b or 3 and neurological improvement is defined by 8 point reduction of National Institutes of Health Stroke Scale (NIHSS) score at 7 days and an
more » ... 7 days and an improved modified Rankin Scale (mRS £ 2) score at 90 days. Results Overall, 93% had TICI 2b/3 signifying successful recanalization. 46.6% had a reduction in the NIHSS score by 8 points at 1 week. 60% had a good outcome with a mRS £ 2. Mortality was 12.5% (n = 2) with 1deaths due to massive hemorrhage and 1 death due to cardiac cause. Conclusions Major Strokes due to tandem occlusion of ICA and ICA/MCA can be treated successfully with lesser morbidity and mortality if strategized based on the understanding of collateral circulation based on pre-procedure CT angiogram. The number of stenting can be minimized and reserved for only those patients with a poor flow in the proximal ICA and poor collateral circulation and those with carotid dissection.
doi:10.1136/neurintsurg-2019-snis.216 fatcat:c3t643zweve63hebylvzuxuo5u