Prevalence and Outcomes of Intracranial Hemodynamic Steal in Symptomatic Internal Carotid Artery Occlusions (P5.223)

Objective: To describe prevalence, risk factor profiling and outcomes of intracranial hemodynamic steal(HS) in symptomatic ICA occlusions. Background: Paradoxical intracranial HS is a known phenomenon in patients having persistent middle cerebral artery(MCA) occlusions or internal carotid artery occlusions(ICAO). This may be associated with symptom worsening or stroke recurrence. Design/Methods: Patients were prospectively recruited with inclusion criteria: age>18 years, TIA/Acute ischemic stroke Results: 21 symptomatic patients (age 57±12 years; 19M:2F) having ICA occlusion (7Lt:2Rt) underwent TCD monitoring at median 17 days (IQR:8–28) from symptom onset. Prevalence of HS was 43% (n=9) having median magnitude, 9% (IQR, 3%–18%). 8 (89%) were hypertensive, 7 (78%) had diabetes, 4 (44%) had dyslipidemia, 5 (56%) were smokers, 7 (78%) were alcoholic and 5 (56%) had family history of stroke. None had symptom recurrence on median follow up of 133 days (IQR, 116–159 days). At 3 months follow up, 7 had modified Rankin Scale (mRS) 0–2 and 2 had mRS >2 with mean steal magnitude 7.7% and 16.5% respectively. Conclusions: HS is common in patients with ICA occlusions. HS may influence outcome of patients with ICAO. Clinical significance of HS needs further evaluation. Disclosure: Dr. Kumar has nothing to disclose. Dr. Khurana has nothing to disclose. Dr. Ahuja has nothing to disclose. Dr. Khandelwal has nothing to disclose. Dr. Singh has nothing to disclose. Dr. Mohanty has nothing to disclose.