Abstract Number ‐ 159: Intubation for Patients Undergoing Mechanical Thrombectomy of DiVOs is Associated with Increased Symptomatic ICH

Abstract

Introduction Distal vessel occlusions (DiVO) represent the next frontier of interventional stroke care. Some practitioners advocate for intubatingDiVOpatients to facilitate roadmapping techniques and vessel selection to assure procedural success. However, prior work studying thrombectomy in large vessel occlusion (LVO) suggests intubation is associated with worse outcomes. We sought to examine whether this relation also exists inDiVOpatients. Methods A prospectively maintained neuro‐endovascular database was queried for patients between January 2013 to August 2022. Patients included in the analysis had undergone mechanical thrombectomy of distal circulation defined as M2, M3, P2, P3, A2 and A3 segments of the MCA, PCA, and ACA respectively.Primary outcomes measured were NIHSS at 24 hours and at discharge. Secondary outcomes measured was the occurrence of symptomatic ICH post procedure. Results A total of 33 patients fit inclusion criteria among our database containing 826 mechanical thrombectomies. While there were more males in the endotracheal intubation group (p = 0.03), there were no other differences in baseline characteristics such as hypertension, diabetes, or prior antiplatelet medication use. Amongst the intubated cohort, we found increased rate of symptomatic intracerebral hemorrhage (ICH) (p = 0.03), worse NIHSS at 24 hours (p = 0.01), and worse NIHSS at hospital discharge (p = 0.002). Conclusions Endotracheal intubation for mechanical thrombectomy inDiVOpatients also appears to be associated with increased rates of symptomatic ICH which drives worse outcomes at 24 hours and discharge.