E-127 Mechanical thrombectomy. retrospective review of incidences and complications

Introduction and purpose Mechanical thrombectomy is accepted as the best treatment when possible in cases of ischemic stroke. Since indications are getting broader in terms of age, time of stroke evolution or NIHSS and ASPECTS records, we frequently face the decision of the convenience to treat borderline patients, for example oligosymptomatic cases. We aimed to review our complications in terms of frequency, age and location in order to help us in taking treatment decisions. Material and methods This study is based in a retrospective review of our database. Since 2010 we have registered 629 cases of mechanical thrombectomy. From these, data of 620 have been considered well completed and have been entered in this study. Considering the thrombectomy itself, three groups have been differentiated: Uncomplicated cases, those presenting complications, and those in which some incidence has been noted. Results Out of 620 thrombectomies included in this review, no incidents have been recorded in 499 (80%) cases. A total of 135 incidences or complications have been noted (some patients had more than one). These were distributed as follows: 25 (4%) cases of haemorrhage or contrast extravasation, 18 (2,9%) cases of arterial dissection, 15 (2,4%) cases of puncture site hematoma, 1 patient (0,16%) presented a carotid-cavernous fistula, 5 (0,8%) cases of in-stent thrombosis, significant embolic events were noted in 43 (6,9%) patients, 24 (3,9%) related to the same territory of the thrombus location, and 19 (3%) extending to another territory. Severe vasospasm has been recorded in 7 (1,1%) cases, material related in 8 (1,3%), and general complications such as allergic reaction or heart arrest in 6 (1%) of cases. Mortality directly attributed to the technique has been considered in 11 (1,8%) cases, most of them in keeping with arterial rupture. Conclusion Technical and angiographical incidences as well as complications are relatively frequent in mechanical thrombectomy. Among other factors, this can be attributed to patient‘s age, to the fact of needing a blind access to distal vessels, to the embolic material itself or to vascular atheromatous occlusion. Most of these complications, however, are transient or very much associated to the disease, and the fact of overcoming them is linked to the general state of the patient. Mortality related to the thrombectomy itself in our series has been recorded in less than 2% of cases. Disclosures M. de Miquel: None. L. Aja: None. S. Aixut: None. R. Barranco: None. O. Chirife: None. P. Cardona: None. H. Quesada: None. B. Lara: None. A. Paipa: None.