Abstract WP64: Ultra-early Treatment With IV tPA for Large Artery Occlusion Improves Recanalization Rates and Clinical Outcomes

Introduction: Emergent large vessel occlusions (ELVO) cause approximately 45% of ischemic strokes and are associated with poor outcomes. With the advent of intra-arterial therapy (IAT), the role of IV tPA for treatment of ELVO stroke has been questioned. We hypothesized that ultra-early treatment with IV tPA for ELVO stroke improves recanalization rates and clinical outcomes. Methods: Retrospective chart review was performed of patients who received IV tPA for ELVO stroke and were treated at our institution between January 2013 and December 2016. We compared patients treated with IV tPA within 60 minutes of being last known well (LKW) with patients treated beyond 60 minutes in regards to (1) recanalization, defined as complete reconstitution of blood flow on arterial imaging, (2) early neurological improvement, defined as National Institute of Health Stroke Scale (NIHSS) of ≤ 1 or decline by ≥ 5 points at 24 hour post-IV tPA, (3) 90 day functional status measured by modified Rankin Scale (mRS), and (4) mo...