Mechanical thrombectomy of the anterior circulation ischemic stroke whatever the low-volume operator : comparison to a 90 days follow-up.

BackgroundTo date, benefit of successful recanalization of acute stroke has been described mainly for high volume operator. PurposeTo evaluate if a successful MT performed by a low-volume operator is a strong predictor of patients good clinical outcome. Materials and MethodsA consecutive monocentric observational study from June 1, 2016 to December 31, 2018 at the University Hospital of Poitiers. Patient management included mechanical thrombectomy and eventual IVT. The interventional neuroradiologist on duty classified the recanalization according a standardized mTICI reading grid. {triangleup}mRS was defined as the difference between 90 days and initial mRS. Association were studied using Chi-square test and Pearsons and Fishers correlation with a threshold at 0.05. The main criterion was the reliability between mTICI and {triangleup}mRS. ResultsAmong the 304 MT, 127 patients were finally included. High mTICI score was significantly associated with high {triangleup}mRS (p = 0.04), using the mTICI dichotomization, patients with successful MT had significantly better outcome than patient with lower mTICI whatever the initial mRS (p = 0.008). There was a correlation between age categories greater than or equal to 80 y.o (p=0.03) and high initial NIHSS categories greater than or equal to 18 (p=0.004) with regard to the {triangleup}mRS. No statistical significance were obtained between sexe (p=0.63), diabetes mellitus (p=0.25), VIT (p=0.16) and thrombuss lateralization (p=0.26) with regard to {triangleup}mRS. ConclusionThis study highlights the place and performances of low-volume operator in the treatment of acute stroke. Summary StatementDespite low-volume operators, a successful mechanical thrombectomy is a strong prognostic factor for good clinical outcome. Key Results- Mechanical thrombectomy performed in a low volume center is a safe therapy and strongly linked to good clinical outcome. - Our low volume-operators centre has reached a high reperfusion rate and a majority of good clinical outcome - This study highlights the place and performances of low-volume operator in the treatment of acute stroke.