Bridging in Acute Ischemic stroke In India- Experience Of Indo-US Stroke Project (P4.282)

OBJECTIVE: To study outcomes of bridging therapy in acute ischemic stroke (AIS) in the Indo-US stroke registry. BACKGROUND: Multicenter experience of Bridging therapy in AIS is lacking from the Indian subcontinent. We report the experience from 5 high volume tertiary care hospitals across India DESIGN/METHODS: The Indo-US Stroke Registry and Infrastructure Development Project, jointly funded by NINDS and DBT,India, currently include 5 geographically diverse centers in India and one in Boston, USA.The registry data was entered into a central web-based electronic database. RESULTS: From Nov-2012 to July-2014, 1944 patients were enrolled. Mean age was 58±14 yrs (range 18-92). 29 Acute strokes with major artery occlusions underwent bridging therapy (IV+IA / IV+device). There were 16(55.2[percnt])males, mean age 56 ± 15 (Range 30-82) years.Stroke types were 44.8[percnt] large artery atherosclerosis, 31.0[percnt] cardioembolic,3.4[percnt] small artery atherosclerosis and 20.7[percnt] undetermined. 55.2[percnt] were M1 occlusions,17.2[percnt] M2,12[percnt] Basilar, 6.9[percnt] PCA and 6.8[percnt] ACA.Dose of IV tPA used was 0.9mg/kg.Median IV thrombolysis to Groin puncture time was 85 min(IQR 37-115).Complete Recanalization (TICI 2b-3) was seen in 22 patients (78.6[percnt]). There were no symptomatic intracranial hemorrhages. Good outcome(mRS 0-2)at 90 days was seen in in 9 (31.0[percnt]) patients. Mortality was 3.4[percnt].90 day outcomes were not available for 17.2[percnt]. Shorter IV thrombolysis to Groin puncture time was associated with good outcomes.(p=0.05) CONCLUSIONS: Bridging therapy in AIS is an emerging option with acceptable safety and good outcomes in developing countries like India for treating large artery occlusions which fail IV thrombolysis Study Supported by: NINDS and DBT,India(R21NS077442). Disclosure: Dr. Khurana has nothing to disclose. Dr. Sylaja has nothing to disclose. Dr. Pandian has received personal compensation for activities with Intas Phamaceuticals and Sanofi-Aventis as an advisor. Dr. Padma has nothing to disclose. Dr. Kaul has nothing to disclose. Dr. Arora has nothing to disclose. Dr. Thankachan has nothing to disclose. Dr. Kaur has nothing to disclose. Dr. Singhal has received personal compensation for activities as a medicolegal expert witness. Dr. Singhal9s spouse holds stock and/or stock options in Biogen Idec.