Non-contrast CT Head Hyperdense Lesions Following Endovascular Therapy With or Without IV tPA Application And Their Effects On Clinical Outcome (1723)

Objective: To determine the relevance of hyperdense lesions following endovascular therapy (EVT) for ischemic stroke and their effects on the clinical outcome and potential reduction of repeat CT head imaging. Background: Hyperdense lesions following EVT for ischemic stroke is a common finding on CT scans. Without a dual energy CT scanner, it is often not clear whether the patient has contrast staining versus hemorrhage until obtaining a repeat CT scan or MRI brain. Repeating the CT head can be helpful when it shows resolution of the lesion but also causes further exposure to radiation, transport of the patient and related risks, extra use of human resources, and cost for the hospital. MRI brain is usually not obtained in the early hours after EVT. Design/Methods: Our study includes around 300 patients from Jan 1st, 2018 until Dec 31st, 2019 either presented directly to our center or transferred from regional hospitals. We retrospectively collected the variables related to demographics; vascular risk factors/comorbidities; clinical variables; EVT variables; radiologic evaluation; other complications; and clinical outcomes (follow up NIHSS and mRS). Results: Our preliminary analysis on limited number of patients shows looking at the absolute change in mRS between groups (hyperdensity/no hyperdensity) using Mann-Whitney U, patients with hyperdensities remained significantly more disabled at discharge (using mRS from baseline to discharge), compared to patients without hyperdensities [2 (1 – 4) vs. 0 (0 – 1)], p =0.04. Patients with hyperdensities remained more disabled at 90 days, compared to baseline, although this difference was not statistically significant [1 (0 – 2) vs. 0 (−1 – 1) ], p = 0.08. Conclusions: Given the change of endovascular therapy practice with different devices and imaging analysis in recent years and because of wide range of variables and protocols in multiple studies, further research is needed to assess potential risk factors for poor outcome. Disclosure: Dr. Sari has nothing to disclose. Dr. Saini has nothing to disclose. Dr. Rana has received personal compensation in the range of $500-$4,999 for serving as a Consultant for CSI. Dr. Rana has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Pharmawrite. Dr. Rana has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biohaven. Dr. Rana has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Argenx. Dr. Rana has received personal compensation in the range of $500-$4,999 for serving as a Consultant for amylyx. Dr. Rana has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Alexion. Neiladri Khan has nothing to disclose. Charles Li has nothing to disclose. Michael Goldberg has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for Tucker IME. Dr. Tayal has nothing to disclose. Dr. Cerejo has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Ischemaview.