Abstract
BackgroundClot burden score (CBS) was developed as a tool to evaluate the extent of intracranial thrombus burden in patients with anterior circulation acute ischemic stroke. Its value in predicting radiographic and clinical outcomes in patients treated with endovascular stroke therapy remains unknown.ObjectiveTo evaluate the relationship between CBS and outcomes after stent retriever thrombectomy in the interventional arm of the SWIFT PRIME trial.MethodsCBS was calculated for the endovascular arm (intravenous tPA plus Solitaire stent retriever) of SWIFT PRIME using baseline CTA. The cohort of 69 patients was divided into 3 groups according to their CBS values: CBS 0–5 (n = 14), CBS 6–7 (n = 23) and CBS 8–9 (n = 32). Association between CBS and outcomes following treatment with the Solitaire device was studied.ResultsThe mean age of the 69 patients who formed the study cohort was 63.2 ± 13.1, mean NIHSS score was 16.8 ± 4.5, and 55% were males. There was no difference in clinical characteristics among the 3 groups, except for the baseline ASPECTS (P = 0.049). The site of proximal occlusion varied significantly among the 3 groups (P < 0.001). Rates of successful recanalization (TICI 2 b/3), complete recanalization (TICI 3 only), and of good clinical outcome at 3 months were similar among the 3 groups. (P = 0.24, P = 0.35, and P = 0.52, respectively).ConclusionsThe combination of IV thrombolysis and stent retriever thrombectomy with the Solitaire device is highly effective in achieving successful recanalization and a good clinical outcome throughout the entire range of CBS values.DisclosuresM. Mokin: None. E. Levy: 4; C; Intratech Medical Ltd., Blockade Medical LLC, Medina Medical. 6; C; Covidien (Medtronic), Abbott, Intratech Medical and Blockade Medical. A. Siddqui: 2; C; Codman & Shurtleff, Inc., Concentric Medical, ev3/Covidien Vascular Therapies, GuidePoint Global Consulting, Penumbra, Stryker, Pulsar Vascular, MicroVention, Lazarus Effect, Blockade Medical. 3; C; Codman & Shurtleff, Inc. 4; C; Hotspur, Intratech Medical, StimSox, Valor Medical, Blockade Medical, and Lazarus Effect. M. Goyal: 1; C; Covidien. 6; C; Covidien. R. Nogueira: 2; C; Stryker. 6; C; Covidien. D. Yavagal: 6; C; Covidien. V. Pereira: 2; C; Medtronic Neurovascular, Stryker. J. Saver: 1; C; Covidien. 6; C; Medtronic, Covidien, Stryker, Neuravi, BrainsGate, Pfi zer, Bristol-Myers Squibb, Boehringer Ingelheim.