Background and Purpose-Previous work that predated the availability of the safer stent-retriever devices has suggested that general anesthesia (GA) may have a negative impact on outcomes in patients with acute ischemic stroke undergoing endovascular therapy. Methods

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34.8%, p=0.02) had lower rates of DM (12% vs 24.9%, p=0.047) and pre-procedure glucose levels (114[104-143] mg/ dl vs 126 , p=0.013). Other baseline characteristics and procedural parameters were comparable between groups. In terms of outcomes, rates of successful reperfusion (mTICI 2b-3) (92%% vs 91.9%, p=1.0) and any parenchymal hematomas (PH) (8.3% vs 13.3%, p=0.34) were comparable. There was a non-significant trend toward better 90-Day independent outcomes (mRS 0-2) and higher 90-day mortality favoring octogenarians (13.6% vs 25.3%, p=0.094 and 52.3% vs 38.7%, p=0.095 respectively) while ambulatory outcomes were more similar (mRS 0-3) (38.1% vs 41.9%, p=0.212). There was a non-significant shift in the overall distribution of 90-day mRS favoring octogenarians. In multivariate analysis, baseline NIHSS, ASPECTS, IV t-PA, Successful reperfusion (mTICI 2b-3) and any PH were independent predictors of a favorable shift in mRS while age category was not. A FIV £16.9 ml (sensitivity 67%, specificity 75%) in octogenarians and less than 12.8 mL (sensitivity 79%, specificity 80%) in nonagenarians demonstrated the greatest accuracy for identifying good outcomes. Conclusions Our study shows that there were no differences in procedural and clinical outcomes between nonagenarians and octogenarians treated with ET with more than 1/3 of nonagenarians were ambulatory at 90 days. However, advanced age seems to be associated with reduced tolerance for infarct volume. Further research is needed to optimize selection modalities in this age cohort.

Introduction/Purpose IMS3 demonstrated no significant difference between treatment with IV-rtPA alone or IV-rtPA plus IA therapy. However, the trial included only earlier generations of thrombectomy devices and did not evaluate the efficacy of newer devices. Here, we present data on an “IMS-III-Like group” from The North American SOLITAIRE Acute Stroke (NASA) Registry, a repository database of the newer generation Solitaire Stent-retriever. An exploratory analysis was performed to compare these results to the IMS3 IV and IV/IA groups. Materials and Methods The investigator-initiated NASA Registry recruited sites to submit data on consecutive patients treated with Solitaire-FR. A cohort similar to the IMS-III IV-rtPA+Solitaire-FR population (NASA-IMS3 Matched Group (NIMG)) was identified and compared to the recently published results of the IMS3 IV and IV/IA groups. Good clinical outcome was defined as a 90-day mRS ≤2. Successful recanalisation was defined as TIMI ≥2. SICH was defined as any parenchymal haematoma, SAH, or IVH associated with a worsening of the NIHSS score by 4 or more within 24 hours. Results 354 acute ischaemic stroke patients were enrolled in the NASA Registry from 24 centres. The cohorts were comprised of: 156 NIMG versus 434 and 222 in the IMS3 IV/IA and IV only groups, respectively. Baseline demographics were similar between cohorts: Median age 70 (NIMG); 69 (IMS3 IV/IA); 70 (IMS3 IV). Initial median NIHSS was higher in NIMG (19) compared to the IMS3 IV/IA (17) and IMS3 IV groups (18). mTICI > 2b rate was 69.9% in NIMG versus 39.6% in the IMS III IV/IA. Interestingly, mTICI 3 rate was 41% in NIMG vs 2.2% in the IMS III IV/IA group. The 90-day mRS outcome was available in 88.5% (138/156) of NIMG patients. A good outcome of mRS?2 was demonstrated in 51.5% (71/138), compared to 40.8% (169/415) in IMS3 IV/IA and 38.7% (83/215) in IM3 IV alone groups. 90-day mortality was 24.6% in NIMG versus 19.1% and 21.6% in IMS3 IV/IA and IV alone groups, respectively. Abstract O-003 Table 1 NASA IMS III IMS III Characteristic IV-tPA+Solitaire IV-tPA+IA IV-tPA Only (N=156) (N=434) (N=222) Age-yrs.(median, range) 70 (28-100) 69 (23-89) 68 (23-84) Male sex - no. (%) 80 (51.3) 218 (50.2) 122 (55.0) Black race - no. (%) 27 (17.6) 51 (11.8) 19 (8.6) A Fib - no. (%) 66 (42.6) 153 (35.3) 70 (31.5) HTN 114 (73.5) 319 (73.5) 171 (77.0) DM 35 (22.6) 94 (21.7) 54 (24.3) CAD 40 (25.8) 102 (23.5) 72 (32.4) NIHSSi - (median, range) 19 (9-40) 17 (7-40) 16 (8-30) SBPi - (mean±SD) 143.3±26.9 148±21.3 147.3±24.0 mRS ≤2 (N 138 vs 415) 71/138 (51.5) 169/415 (40.8) 83/215 (38.7) mTICI ≥ 2b-3 109/156 (69.9) 126/318 (39.6) NA mTICI 3 64/156 (41.03) 7/318 (2.2) NA sICH 18 (11.6) 27 (6.2) 13 (5.9) Death within 90 days - no. (%) 34/138 (24.6) 83 (19.1) 48 (21.6) Conclusion In the NASA registry, the NASA-IMS3 Matched Group (NIMG) demonstrated a higher rate of good clinical outcome (51.5%) compared to the IMS3 IV/IA (40.8%) and IV alone (34.6%) groups. Disclosures R. Nogueira: None...

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the cases and classified in an ordinal scale: indentation (3.6%), flutter (8.9%), focal (7.7%) and full collapse (67.3%). Focal to full arterial collapse was observed in the M2 regardless of catheter size and perfusion pressure. The likelihood and severity of collapse was positively correlated to size of aspiration catheter and negatively correlated to arterial size and perfusion pressure. OCT detected collapse of the aortic lumen during aspiration thrombectomy in rabbit. Conclusion Arterial collapse occurs with current aspiration thrombectomy technologies in validated human brain models and in vivo in the aorta of rabbit.

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