E-098 Mechanical thrombectomy in the extended 24 hour time window for acute ischemic stroke patients with large vessel occlusion

Abstract

ConclusionThe shorter and simpler PREDICT scale was found to be less preferable with EMS provider all-comers, which may be partially due to the mere-exposure cognitive bias effect though this difference persisted in providers who had no prior exposure to either scale. In providers who enrolled multiple patients, there was a statistically insignificant trend towards preference for RACE between their first and last screening.

Late Thrombectomy in Clinical Practice

“…This applies to all patients in our cohort treated ≥ 6-24 h, and even for those patients who would have formally met the study criteria (mRS = 0-2: 20% in our cohort vs. 48% in DAWN and 44% in DEFUSE3). This is in line with a recent single-center analysis by Salam et al (n = 166) where good functional outcome occurred in 24% [17]. The BEST cohort [9], another real-life study, also found worse clinical results of trial-eligible patients when compared to the randomized studies, but these were more favorable than in our cohort (mRS 0-2 = 30%, 14/47); however, the estimated infarct core volumes in BEST were very small (6 ml [0-20]) [9].…”

“…In line with our results, in a subgroup of those patients with a significantly larger core volume (45.2 ml [37-60]) and thus ineligibility for both trials, the percentage of good outcomes dropped to 24% (8/33) [4]. Within the BEST registry, 36% (16/45) of trial ineligible patients reached a good outcome, but NIHSS on admission (12 [7][8][9][10][11][12][13][14][15][16][17][18]) and core volume (15 ml [0-49]) were much lower compared to our cohort, possibly explained by the high rate (41%) of M2 occlusions.…”