E-095 The embotrap stent retriever for treatment of acute ischemic stroke: Impact of hospital procedural volume on real world outcomes

Introduction The EmboTrap® Revascularization Device (CERENOVUS, Johnson & Johnson Medical Devices, Irvine, CA, USA) is an innovative revascularization device with a dual layer design for thrombus retrieval. The objective of this study was to examine the impact of hospital mechanical thrombectomy (MT) volume on clinical outcomes among acute ischemic stroke (AIS) patients treated using the EmboTrap® device. Material and Methods Adult patients (≥18 years), who underwent MT for AIS with the EmboTrap® (alone or with another MT device) from July 2018-December 2019, were identified from the Premier Healthcare Database (PHD). The PHD is a nationwide hospital database, with more than 1,000 hospitals of varying size, location (urban/rural), geographic region, and teaching status. The influence of hospital MT volume (classified into quartiles based on MT volume in the six-month pre-index AIS admission period) on in-hospital mortality, length of stay (LOS), and rate of 30-day readmissions (all-cause and cardiovascular [CV]-related) was assessed. Generalized estimating equation regression was used to examine the relationship between MT volume and outcomes, adjusting for patient demographic and clinical characteristics, and provider characteristics. In addition, the use of other MT devices was controlled in study analyses. A logit link function was used for in-hospital mortality and readmission assessments and a log link function for LOS assessment. The distributions used were binomial distributions for in-hospital mortality and readmission assessments, and negative binomial distributions for LOS assessment. Results The study included 400 patients (mean age 70.5±14.32 years) based on inclusion/exclusion criteria. Hospitals were classified into four volume categories: 139 MT procedures. Patients treated with EmboTrap® (alone or with another MT device) in hospitals in the fourth MT volume quartile (>139 MT procedures) had lower odds of all-cause (odds ratio [OR] 0.22; 95% confidence interval [CI] 0.05-0.96) and CV-related (OR 0.12; 95% CI 0.02-0.65) inpatient readmission as compared to patients treated with EmboTrap® (alone or with another MT device) in hospitals in the first MT volume quartile ( Conclusions Hospital MT volume significantly influenced the rate of readmissions among AIS patients treated with the EmboTrap® (alone or with another MT device) device. The lack of difference in mortality may also be reflective of limited statistical power to detect differences in study groups. Further research to understand the impact of hospital MT volume on patient outcomes, as well as identify the threshold volume that optimizes positive outcomes, could help inform future stroke care guidelines and contribute to improved treatment protocols in low-volume centers. Disclosures S. Ikeme: None. E. Kottenmeier: None. A. Khaled: None. S. M: None. R. Khanna: None.