Rescue thrombectomy after failure of intravenous thrombolysis in acute ischemic stroke: Preliminary results of a multicenter prospective observational study

WCN 2013 No: 2524 Topic: 3 — Stroke Rescue thrombectomy after failure of intravenous thrombolysis in acute ischemic stroke: Preliminary results of a multicenter prospective observational study P. Desfontaines, D. Brisbois, N. Onclinx, C. Daout, O. Cornet, L. Dieudonne, K. Windhausen, A. Maertens de Noordhoudt. Neurology, C.H.C., Site Saint-Joseph, Liege, Belgium; Interventional Neuroradiology, C.H.C., Site Saint-Joseph, Liege, Belgium; Neurology, Centre Hospitalier du Bois de l'Abbaye, Seraing, Belgium; Neurology, Centre Hospitalier Regional de Huy, Huy, Belgium; University Department of Neurology, CHR de la Citadelle, Liege, Belgium Background: Intravenous (iv) thrombolysis has a poor rate (less than 30%) of recanalisation in proximally occluded mean cerebral artery (MCA). Thrombectomy has been shown to achieve a higher rate of recanalisation, up to 80%. The outcome of stroke patients is closely related to the recanalisation rate. A protocol of thrombectomy is prospectively performed in stroke patients with failure of iv thrombolysis in case of proximal MCA occlusion. Material andmethods:All patients admittedwithin the timewindow (4.5 h) for iv thrombolysis had an angioscanner to assess the level of occlusion of MCA. In case of no clinical recovery after iv thrombolysis, a thrombectomy was performed under general anaesthesia in case of persisting proximal occlusion. The device used was the Solitaire FR. ThemRS and the NIHSS were performed at discharge, 3 and 6 months. A CT scan was performed at 24 h, and an angioMRI at one month. Results: 16 patients underwent the procedure. There were 2 cases of procedural failure. The mean age is 64 +/− 10.5 years. The mean NIHSS at admission is 16 +/− 2. From stroke onset, the mean time of iv thrombolysis is 110 +/− 48 min, the mean time of stent deployment is 297 +/− 60 min. Good outcome (mRS 0 to 2) is 78.5% (11/14). Intracranial haemorrhage occurred in 35.7%. The postprocedure angiography showed 12/14 complete recanalisation (TIMI = 3). Conclusions: Our first results show a favourable outcome of stroke patients with failure of iv thrombolysis successfully recanalised by thrombectomy. doi:10.1016/j.jns.2013.07.950 Abstract — WCN 2013 No: 2528 Topic: 3 — Stroke Acute spinal cord infarction: Outcomes of a Portuguese center WCN 2013 No: 2528 Topic: 3 — Stroke Acute spinal cord infarction: Outcomes of a Portuguese center J. Meireles, A. Costa, A. Monteiro, P. Abreu. Neurology, Hospital de Sao Joao, Porto, Portugal; Centro Hospitalar de Sao Joao, Porto, Portugal Introduction: Acute spinal cord infarction syndrome (ASCIS) is responsible for 5–8% of all acute myelopathies. Main causes include aortic pathology, atherosclerosis and infection. Current knowledge of long-term outcome is limited, but seems to be worst for patients with severe deficits and/or no initial improvement. Objective: To examine clinical features and assessmotor and functional outcome of patients with ASCIS. Patients and methods: Retrospective analysis of 104 consecutive patients with spinal cord lesions (from 1989 to 2013). Ten patients presenting with ASCIS were included. Data concerning demographic and clinical variables were analyzed. Neurological syndrome was defined and initial and long term outcomes were assessed using the American Spinal Injury Association (ASIA)motor score and theModified Rankin Scale (mRS). Results: Five women and five men were included (mean age 56.3 years). In 60% of patients the first symptom was motor deficit. Possible causes were atherosclerosis (n = 4), hypoperfusion (n = 1), degenerative spine disease (n = 3) and cryptogenic (n = 2). Mean ASIA motor score was 71.0 ± 15.23 at onset and 75.3 ± 17.4 24 h after admission. Median mRS was significantly worse at discharge (median 4, range 1–4) when compared to admission (median 0, range 0–2) (p = 0.010), but there was no change at one year followup (median 3, range 1–4) when compared to discharge (p = 0.18). Worst ASIA scores 24 h after admission correlated with worst mRS at discharge (p b 0.05). Conclusion: In this series motor outcome was fundamentally related to the severity of the neurological deficits at presentation. Nevertheless, the majority of patients regained ambulatory capacity. doi:10.1016/j.jns.2013.07.951 Abstract — WCN 2013 No: 2550 Topic: 3 — Stroke Beyond DWI — Emerging candidate MRI biomarkers associated with risk of early stroke after TIA WCN 2013 No: 2550 Topic: 3 — Stroke Beyond DWI — Emerging candidate MRI biomarkers associated with risk of early stroke after TIA L. Akijian, F. Carty, J. Thornton, R. Grech, E. Kavanagh, A. Merwick, D. Ni Chroinin, N. Hannon, O. Sheehan, M. Marnane, E.L. Callaly, E.M. Fallon, G. Horgan, T. Lynch, K. O'Rourke, J. Duggan, L. Kyne, S. Murphy, E. Dolan, D. Williams, P.J. Kelly. Neurovascular Unit for Applied Translational Research and Therapeutics, Dublin, Ireland; Neuroradiology, The Mater Misericordiae University Hospital, Dublin, Ireland; Neuroradiology, Beaumont Hospital, Dublin, Ireland; Neurology and Stroke, Dublin, Ireland; Medicine for Elderly and Stroke, The Mater Misericordiae University Hospital, Dublin, Ireland; Medicine for Elderly and Stroke, Beaumont Hospital, Dublin, Ireland Background: Early recurrent stroke is a major cause of disability after TIA. The presence of acute DWI hyperintensity after TIA Abstracts / Journal of the Neurological Sciences 333 (2013) e215–e278 e245