International Stroke Conference 2025  /  Neuroendovascular Oral Abstracts I  /  Bridging thrombolysis prior to thrombectomy does not modify the association between Direct-to-angiography vs Repeat Imaging approaches and functional outcomes after EVT in transferred patients
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American Heart Association

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Final ID: 9

Bridging thrombolysis prior to thrombectomy does not modify the association between Direct-to-angiography vs Repeat Imaging approaches and functional outcomes after EVT in transferred patients

Abstract Body: Introduction: For patients transferred for EVT considerations, direct-to-angio approach is shown to reduce time to procedure and improve clinical outcomes. We aimed to assess if IV thrombolytics status prior to transfer modifies the association between direct-to-angio approach and improved clinical outcomes in transferred patients who received EVT.
Methods: In a secondary analysis of a retrospective cohort of transferred EVT patients from 6 centers across US and Europe, patients were stratified based on IV thrombolytic status. Association of direct-to-angio approach vs repeated imaging approach with functional outcomes was assessed among patients with and without IV thrombolytics using appropriate regression models adjusted for age, stroke severity, time to procedure, occlusion location, serum glucose and successful reperfusion status. Heterogeneity of association was evaluated using multiplicative interaction.
Results: Of 1135 patients with documented IV thrombolysis status, 612 (54%) received IVT – with younger age (IVT - 68 (57-78)y, no IVT - 70 (60-79)y, p=0.032) and higher CT ASPECTS (IVT: 8 (7-10) vs no IVT: 8 (7-9), p=0.038), but similar NIHSS (IVT: 17 (13-21) vs no IVT: 17 (12-21), p=0.91). Estimates of association favored direct-to-angio approach among both no IVT (acOR: 2.06, 95% CI: 1.38 to 3.08, p-value<0.001) and IVT (acOR: 1.33, 95% CI: 0.95 to 1.86, p-value: 0.099), without significant heterogeneity (p-interaction: 0.17). Similar findings were also observed for functional independence (IVT - aOR: 1.64, 95% CI: 1.08 to 2.49, p-value: 0.021; no IVT: aOR: 2.12, 95% CI: 1.25 to 3.58, p-value: 0.005; p-interaction: 0.57) and independent ambulation (IVT: aOR: 1.45, 95% CI: 0.93 to 2.26, p-value: 0.097; No IVT: aOR: 2.92, 95% CI: 1.68 to 5.06, p-value<0.001; p-interaction: 0.10) – Table 1.
Interpretation: From a retrospective cohort of transferred patients who received EVT, use of IV thrombolytics at baseline did not modify the association between DTA vs RI approach and functional outcomes at 90-day follow-up, suggesting the feasibility of DTA approach regardless of baseline IVT status.
  • Shafiq, Ameena  ( University Hospitals Cleveland Medical Center , Cleveland , Ohio , United States )
  • Elijovich, Lucas  ( SEMMES-MURPHEY CLINIC , Memphis , Tennessee , United States )
  • Dannenbaum, Mark  ( The University of Texas Health Science Center , Houston , Texas , United States )
  • Mir, Osman  ( TSI , Coppell , Texas , United States )
  • Tekle, Wondwossen  ( The University of Texas Rio Grande Valley , Edinburg , Texas , United States )
  • Maali, Laith  ( University of Kansas Health System , Kansas City , Kansas , United States )
  • Narangoli, Adeeb  ( University Hospitals Cleveland Medical Center , Cleveland , Ohio , United States )
  • Yaghmoor, Bassam  ( University Hospitals Cleveland Medical Center , Cleveland , Ohio , United States )
  • Al-shaibi, Faisal  ( University Hospitals Cleveland Medical Center , Cleveland , Ohio , United States )
  • Saidi, Yazid  ( University Hospitals Cleveland Medical Center , Cleveland , Ohio , United States )
  • Al Mostaneer, Alhassin  ( University Hospitals Cleveland Medical Center , Cleveland , Ohio , United States )
  • Pujara, Deep  ( University Hospitals Cleveland Medical Center , Cleveland , Ohio , United States )
  • Albedaiwi, Mohammed  ( University Hospitals Cleveland Medical Center , Cleveland , Ohio , United States )
  • Montgomery, Kelly  ( University Hospitals Cleveland Medical Center , Cleveland , Ohio , United States )
  • Sundararajan, Sophia  ( University Hospitals Cleveland Medical Center , Cleveland , Ohio , United States )
  • Opaskar, Amanda  ( University Hospitals Cleveland Medical Center , Cleveland , Ohio , United States )
  • Xiong, Wei  ( University Hospitals Cleveland Medical Center , Cleveland , Ohio , United States )
  • Degeorgia, Michael  ( University Hospitals Cleveland Medical Center , Cleveland , Ohio , United States )
  • Duncan, Kelsey  ( University Hospitals CMC , Cleveland , Ohio , United States )
  • Ray, Abhishek  ( University Hospitals Cleveland Medical Center , Cleveland , Ohio , United States )
  • Hu, Yin  ( UH Cleveland Medical Center - CWRU , Cleveland , Ohio , United States )
  • Sunshine, Jeffrey  ( University Hospitals Cleveland Medical Center , Cleveland , Ohio , United States )
  • Goyal, Nitin  ( The University of Tennessee Health Science Center , Memphis , Tennessee , United States )
  • Alenzi, Bader  ( King Fahad Specialist Hospital , Dammam , Saudi Arabia )
  • Abdulrazzak, Mohammad  ( Cleveland Clinic , Cleveland , Ohio , United States )
  • Hoit, Daniel  ( The University of Tennessee Health Science Center , Memphis , Tennessee , United States )
  • Martin-schild, Sheryl  ( Dr. Brain, Inc. , Metairie , Louisiana , United States )
  • Song, Sarah  ( Rush University Medical Center , Chicago , Illinois , United States )
  • Sitton, Clark  ( UT Houston McGovern Medical School , Houston , Texas , United States )
  • Tsivgoulis, Georgios  ( Neurodiagnostics PC , Athens , Greece )
  • Arthur, Adam  ( Semmes-Murphey Neurological Clinic , Memphis , Tennessee , United States )
  • Sila, Cathy  ( University Hospitals Cleveland Medical Center , Cleveland , Ohio , United States )
  • Bambakidis, Nicholas  ( University Hospitals Cleveland Medical Center , Cleveland , Ohio , United States )
  • Chen, Michael  ( Rush University Medical Center , Chicago , Illinois , United States )
  • Hassan, Ameer  ( UTRGV - VALLEY BAPTIST MEDICAL CENT , Harlingen , Texas , United States )
  • Ribo, Marc  ( HOSPITAL VALL D HEBRON , Barcelona , Spain )
  • Sarraj, Amrou  ( University Hospitals Cleveland Med , Cleveland , Ohio , United States )
  • Grotta, James  ( The University of Texas Health Science Center , Houston , Texas , United States )
  • Blackburn, Spiros  ( University of Texas Houston Health Science Center , Houston , Texas , United States )
  • Requena, Manuel  ( Vall dHebron Hospital , Barcelona , Spain )
  • Kamal, Haris  ( MEMORIAL HEALTHCARE SYSTEM , Fort Lauderdale , Florida , United States )
  • Abraham, Michael  ( UNIVERSITY OF KANSAS HOSPITAL , Kansas City , Missouri , United States )
    • Author Disclosures:
    Ameena Shafiq: DO NOT have relevant financial relationships | Lucas Elijovich: No Answer | Mark Dannenbaum: No Answer | Osman Mir: DO NOT have relevant financial relationships | Wondwossen Tekle: No Answer | Laith Maali: DO NOT have relevant financial relationships | Adeeb Narangoli: DO NOT have relevant financial relationships | Bassam Yaghmoor: DO NOT have relevant financial relationships | Faisal Al-Shaibi: DO NOT have relevant financial relationships | Yazid Saidi: DO NOT have relevant financial relationships | Alhassin Al Mostaneer: DO NOT have relevant financial relationships | Deep Pujara: DO NOT have relevant financial relationships | Mohammed Albedaiwi: DO NOT have relevant financial relationships | Kelly Montgomery: DO NOT have relevant financial relationships | Sophia Sundararajan: DO NOT have relevant financial relationships | Amanda Opaskar: No Answer | Wei Xiong: DO NOT have relevant financial relationships | Michael DeGeorgia: No Answer | Kelsey Duncan: DO NOT have relevant financial relationships | Abhishek Ray: No Answer | Yin Hu: DO NOT have relevant financial relationships | Jeffrey Sunshine: No Answer | Nitin Goyal: No Answer | Bader Alenzi: No Answer | Mohammad Abdulrazzak: No Answer | Daniel Hoit: DO have relevant financial relationships ; Individual Stocks/Stock Options:Silver Bullett:Active (exists now) ; Individual Stocks/Stock Options:REVbio:Active (exists now) ; Independent Contractor:MDReview:Active (exists now) ; Consultant:Penumbra:Active (exists now) ; Consultant:stryker:Active (exists now) ; Consultant:Microvention:Active (exists now) ; Speaker:IMperative:Active (exists now) | Sheryl Martin-Schild: DO have relevant financial relationships ; Speaker:AstraZeneca:Active (exists now) | Sarah Song: No Answer | clark sitton: DO NOT have relevant financial relationships | Georgios Tsivgoulis: DO NOT have relevant financial relationships | Adam Arthur: DO have relevant financial relationships ; Consultant:Arsenal:Active (exists now) ; Individual Stocks/Stock Options:Scientia:Active (exists now) ; Consultant:Stryker:Active (exists now) ; Consultant:Siemens:Active (exists now) ; Consultant:Scientia:Active (exists now) ; Consultant:NV Medtech:Active (exists now) ; Consultant:Mendaera:Active (exists now) ; Consultant:Perfuze:Active (exists now) ; Consultant:Penumbra:Active (exists now) ; Consultant:Nuvascular:Active (exists now) ; Consultant:Neuros:Active (exists now) ; Consultant:Medtronic:Active (exists now) ; Consultant:Inretio:Active (exists now) ; Consultant:Cerenovus:Active (exists now) ; Consultant:Balt:Active (exists now) | Cathy Sila: DO NOT have relevant financial relationships | Nicholas Bambakidis: DO have relevant financial relationships ; Research Funding (PI or named investigator):Idorsia Pharmaceuticals:Past (completed) | Michael Chen: No Answer | Ameer Hassan: DO have relevant financial relationships ; Consultant:Medtronic, Microvention, Stryker, Penumbra, Cerenovus, Genentech, GE Healthcare, Scientia, Balt, Viz.ai , Insera therapeutics, Proximie, NeuroVasc, NovaSignal, Vesalio, Rapid Medical, Imperative Care, Galaxy Therapeutics, Route 92, Perfuze, CorTech, Shockwave and Xcath:Active (exists now) | Marc Ribo: DO NOT have relevant financial relationships | Amrou Sarraj: DO have relevant financial relationships ; Research Funding (PI or named investigator):Stryker Neurovascular:Active (exists now) | James Grotta: DO have relevant financial relationships ; Consultant:Frazer Ltd:Active (exists now) ; Advisor:Prolong Pharma:Active (exists now) ; Advisor:Acticor:Active (exists now) ; Advisor:Diamedica:Active (exists now) | Spiros Blackburn: DO NOT have relevant financial relationships | Manuel Requena: DO NOT have relevant financial relationships | Haris Kamal: DO have relevant financial relationships ; Consultant:Microvention - Terumo:Past (completed) ; Consultant:Scientia vascular :Past (completed) | Michael Abraham: DO have relevant financial relationships ; Consultant:Stryker Neurovascular:Active (exists now) ; Consultant:Q'Apel Medical:Active (exists now)
Meeting Info:

International Stroke Conference 2025

2025

Los Angeles, CA

Session Info:

Neuroendovascular Oral Abstracts I

Wednesday, 02/05/2025 , 07:30AM - 09:00AM

Oral Abstract Session

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