Abstract TMP6: Peri-procedural Complications of Endovascular Treatment for Acute Stroke in SWIFT Trial

Background: Management of patients with ischemic stroke after endovascular treatment requires knowledge of peri-procedural complications. The SWIFT trial compared two devices (Merci and SOLITAIRE) in a randomized, prospective study. We reviewed peri-procedural complications of endovascular treatment and related clinical and technical factors. Methods: The SWIFT database was searched for major peri-procedural complications defined as: symptomatic intracranial hemorrhage (sICH) within 36 hours, symptomatic subarachnoid hemorrhage (SAH), air emboli, vessel dissection, major groin complications, and emboli to new vascular territories. Results: Major peri-procedural complications occurred in 18/144 patients (12.5%) at the following rates: sICH (4.9%); SAH (3.5%), air emboli (1.4%), vessel dissection (4.2%), major groin complications (2.8%), and emboli to new vascular territories (0.7%). We did not observe any statistically significant associations of complications with: age ( 65 y 11.6%); type of center (academic 9.3% vs non-academic 13.9%); duration of stroke symptoms ( 6 h), NIH stroke scale score (NIHSS 20,13.9%), iv thrombolytics (no iv tPA 10.5% vs iv tPA15.2%), atrial fibrillation (absent 10.1% vs present 14.7%), site of vessel occlusion (ICA 19.2%; MCA 11.5%); rescue therapy administered after endovascular treatment (no rescue 11.9% vs rescue 14.9%); or device (Merci 14.5%; Solitaire 11.2%). Comparing the Merci to the Solitaire retrieval device, we observed the following peri-procedural events: Conclusion: Detailed knowledge of peri-procedural complications is important for managing stroke patients after endovascular treatment. Fewer endovascular complications were observed after with SOLITAIRE device treatment compared to Merci device treatment, particularly symptomatic cerebral hemorrhage. Device registries will be helpful to gain deeper understanding of rare events.