1210. Selection Criteria for Posterior Circulation Stroke and Functional Outcome Following Mechanical Thrombectomy

Authors: Ahmad Sweid; Stavropoula Tjoumakaris, MD; Vivian Xu, BS; Kavya Shivashankar, BA; Karim Hafazalla, BS; Michael Gooch, MD; Nabeel Herial, MD; Robert Rosenwasser, MD; Pascal Jabbour, MD (Philadelphia, PA)

Introduction: 20 % of all AIS are caused by posterior circulation stroke which carries an intensified mortality touching 95%. Early recanalization improves outcome as shown by several reports. However, safety, patient selection and prognostic factors are still lacking. Authors opt to investigate the safety and prognostic factors for posterior circulation mechanical thrombectomy Methods: A retrospective review of patients presenting with posterior circulation AIS who underwent mechanical thrombectomy at a tertiary referral center between the 2010 and 2018 Results: Out of 443 patients underwent mechanical thrombectomy for AIS, 83 patients had posterior circulation stroke (average age 60 years, 59 % male). 95 % of the procedures were conducted under general anesthesia. The median NIHSS upon admission was 19.1. Half the patient underwent MT after 8 hours from symptom onset and half required a salvage contact thrombus aspiration after a stent retriever trial with an average of two passes for successful recanalization. The time to achieve revascularization was 61.6 min were mTICI > 2b seen in 91 % of the subjects. Mortality rate was 28 % and independent functional outcome of mRS < 2 at three month was seen in 40.1 % of the patients. A higher functional outcome trend (mRS<2) was seen in patients undergoing mechanical thrombectomy < 8 hours. The overall complication rate was 28 %. Regression analysis showed that stroke subtype, baseline NIHSS score and pc-ASPECTS on CT beforethrombectomy were independent predictive factors of good clinical outcome Conclusion: Mechanical thrombectomy procedure for posterior circulation strokes is effective and long term functional independence relies on proper patient selection. Baseline NIHSS and pc-ASPECT score are independent predictive factors