P177/324 To bridge or not to bridge in ICA occlusion, that is the question: single-centre 9-year experience

Introduction

Several randomised controlled trials proved efficacy of mechanical thrombectomy (MT) in treating acute ischemic stroke (AIS) but provided limited data about added benefit of bridging thrombolysis (BT) in AIS caused by internal carotid artery (ICA) occlusion.

Aim of Study

To carry out a retrospective single-centre analysis of prospectively collected data of patients with AIS due to ICA occlusion treated with MT alone or MT+BT to evaluate the impact of BT in this specific subgroup of patients.

Methods

Patients with ICA occlusion treated with MT or MT+BT were retrospectively analysed. Demographic data, risk factors, technical and clinical outcomes and complications were compared. Propensity score (PS) analysis was used to compare modified Rankin Scale (mRS) score and mortality at 3 months after treatment between groups.

Results

105 patients (51% MT/49% MT+BT) treated between September 2013 and December 2022 were included. There was a higher number of wake-up strokes (31% vs 11%, p=0.029) and female patients (46% vs 23%, p=0.014) in MT group, otherwise baseline characteristics did not differ. There was no difference in reperfusion success, complications, and technical aspects between groups. The rate of symptomatic intracranial haemorrhage did not differ among groups (12% vs 9%, p=0.761). PS analysis showed no significant difference in mRS ≤2 at 3 months (OR=1.417, 95% CI 0.6–3.4, p=0.436) as well as no difference in mortality at 3 months (OR=1.329, 95% CI 0.5–3.2, p=0.532).

Conclusion

We observed no significant difference in clinical outcome at 3 months after treatment between patients treated with MT alone versus MT+BT.

Disclosure of Interest

Nothing to disclose