Poor natural history of large vessel acute ischemic stroke underscores the need for mechanical thrombectomy: natural history FIRST stroke study interim results

Vallabh Janardhan; Lauren A. Carlson; Ryan M. Gianatasio; Sherman H. Chen; Parita Bhuva; Mark M. Murray; Madhu B. Vijayappa; Paul A. Hansen; Anita Guthmann; Raymond Cheung; Thomas Leung; Iris Grunwald; Heather Hernandez; Leticia Barraza; Hope Buell; Sophia S. Kuo; Arani Bose; Siu Po Sit

Poor natural history of large vessel acute ischemic stroke underscores the need for mechanical thrombectomy: natural history FIRST stroke study interim results

Vallabh Janardhan, Lauren A. Carlson, Ryan M. Gianatasio, Sherman H. Chen, Parita Bhuva, Mark M. Murray, Madhu B. Vijayappa, Paul A. Hansen, Anita Guthmann, Raymond Cheung, Thomas Leung, Iris Grunwald, Heather Hernandez, Leticia Barraza, Hope Buell, Sophia S. Kuo, Arani Bose, Siu Po Sit

Research output: Contribution to journal › Conference article › peer-review

Abstract

Background: Limited information is available on the natural history of the mechanical thrombectomy-eligible stroke cohort. Therefore, FIRST aims to collect real-world data in an appropriate population.
Methods: The FIRST Trial is a prospective natural history study of a stroke cohort eligible for but untreated by endovascular therapy presenting with a large vessel occlusion and ineligible for or unresponsive to IV rtPA. The primary endpoint is 90-day mRS 0–2.
Results: Sixty-one patients met analysis criteria. Mean age was 68; median NIHSS score was 18. Occlusions were in the ICA (28%), MCA (67%) and other (5%). The admission TIMI 0–1 rate was 98% and TICI 0–1 was 98%, in which10% and 12% spontaneously recanalized. Good 90-day out-come was achieved in 22%; 41% died, 54% had SAEs and 56% were IV rtPA-refractory. Compared to PROACT II, the FIRST cohort has substantially different entry criteria, less recanalization and worse outcome.
Conclusion: If untreated, 78% of patients with large vessel acute ischemic stroke will die or suffer long-term disabilities. Results suggest FIRST data could provide a benchmark for future thrombectomy trials. Study supported by: Penumbra, Inc.

Original language	English
Article number	M1304
Pages (from-to)	S55-S55
Number of pages	1
Journal	Annals of Neurology
Volume	74
Issue number	suppl 17
Publication status	Published - 2013
Event	42nd Annual Meeting of the Child Neurology Society - Texas, United States Duration: 30 Oct 2013 → 2 Nov 2013

Cite this

Janardhan, V., Carlson, L. A., Gianatasio, R. M., Chen, S. H., Bhuva, P., Murray, M. M., Vijayappa, M. B., Hansen, P. A., Guthmann, A., Cheung, R., Leung, T., Grunwald, I., Hernandez, H., Barraza, L., Buell, H., Kuo, S. S., Bose, A., & Sit, S. P. (2013). Poor natural history of large vessel acute ischemic stroke underscores the need for mechanical thrombectomy: natural history FIRST stroke study interim results. Annals of Neurology, 74(suppl 17), S55-S55. Article M1304.

@article{2038fa0fb34a4535962bba063a46e82d,

title = "Poor natural history of large vessel acute ischemic stroke underscores the need for mechanical thrombectomy: natural history FIRST stroke study interim results",

abstract = "Background: Limited information is available on the natural history of the mechanical thrombectomy-eligible stroke cohort. Therefore, FIRST aims to collect real-world data in an appropriate population. Methods: The FIRST Trial is a prospective natural history study of a stroke cohort eligible for but untreated by endovascular therapy presenting with a large vessel occlusion and ineligible for or unresponsive to IV rtPA. The primary endpoint is 90-day mRS 0–2.Results: Sixty-one patients met analysis criteria. Mean age was 68; median NIHSS score was 18. Occlusions were in the ICA (28%), MCA (67%) and other (5%). The admission TIMI 0–1 rate was 98% and TICI 0–1 was 98%, in which10% and 12% spontaneously recanalized. Good 90-day out-come was achieved in 22%; 41% died, 54% had SAEs and 56% were IV rtPA-refractory. Compared to PROACT II, the FIRST cohort has substantially different entry criteria, less recanalization and worse outcome.Conclusion: If untreated, 78% of patients with large vessel acute ischemic stroke will die or suffer long-term disabilities. Results suggest FIRST data could provide a benchmark for future thrombectomy trials. Study supported by: Penumbra, Inc.",

author = "Vallabh Janardhan and Carlson, {Lauren A.} and Gianatasio, {Ryan M.} and Chen, {Sherman H.} and Parita Bhuva and Murray, {Mark M.} and Vijayappa, {Madhu B.} and Hansen, {Paul A.} and Anita Guthmann and Raymond Cheung and Thomas Leung and Iris Grunwald and Heather Hernandez and Leticia Barraza and Hope Buell and Kuo, {Sophia S.} and Arani Bose and Sit, {Siu Po}",

year = "2013",

language = "English",

volume = "74",

pages = "S55--S55",

journal = "Annals of Neurology",

issn = "0364-5134",

publisher = "Wiley",

number = "suppl 17",

note = "42nd Annual Meeting of the Child Neurology Society ; Conference date: 30-10-2013 Through 02-11-2013",

}

Janardhan, V, Carlson, LA, Gianatasio, RM, Chen, SH, Bhuva, P, Murray, MM, Vijayappa, MB, Hansen, PA, Guthmann, A, Cheung, R, Leung, T, Grunwald, I, Hernandez, H, Barraza, L, Buell, H, Kuo, SS, Bose, A & Sit, SP 2013, 'Poor natural history of large vessel acute ischemic stroke underscores the need for mechanical thrombectomy: natural history FIRST stroke study interim results', Annals of Neurology, vol. 74, no. suppl 17, M1304, pp. S55-S55.

Poor natural history of large vessel acute ischemic stroke underscores the need for mechanical thrombectomy: natural history FIRST stroke study interim results. / Janardhan, Vallabh; Carlson, Lauren A.; Gianatasio, Ryan M. et al.
In: Annals of Neurology, Vol. 74, No. suppl 17, M1304, 2013, p. S55-S55.

Research output: Contribution to journal › Conference article › peer-review

TY - JOUR

T1 - Poor natural history of large vessel acute ischemic stroke underscores the need for mechanical thrombectomy

T2 - 42nd Annual Meeting of the Child Neurology Society

AU - Janardhan, Vallabh

AU - Carlson, Lauren A.

AU - Gianatasio, Ryan M.

AU - Chen, Sherman H.

AU - Bhuva, Parita

AU - Murray, Mark M.

AU - Vijayappa, Madhu B.

AU - Hansen, Paul A.

AU - Guthmann, Anita

AU - Cheung, Raymond

AU - Leung, Thomas

AU - Grunwald, Iris

AU - Hernandez, Heather

AU - Barraza, Leticia

AU - Buell, Hope

AU - Kuo, Sophia S.

AU - Bose, Arani

AU - Sit, Siu Po

PY - 2013

Y1 - 2013

N2 - Background: Limited information is available on the natural history of the mechanical thrombectomy-eligible stroke cohort. Therefore, FIRST aims to collect real-world data in an appropriate population. Methods: The FIRST Trial is a prospective natural history study of a stroke cohort eligible for but untreated by endovascular therapy presenting with a large vessel occlusion and ineligible for or unresponsive to IV rtPA. The primary endpoint is 90-day mRS 0–2.Results: Sixty-one patients met analysis criteria. Mean age was 68; median NIHSS score was 18. Occlusions were in the ICA (28%), MCA (67%) and other (5%). The admission TIMI 0–1 rate was 98% and TICI 0–1 was 98%, in which10% and 12% spontaneously recanalized. Good 90-day out-come was achieved in 22%; 41% died, 54% had SAEs and 56% were IV rtPA-refractory. Compared to PROACT II, the FIRST cohort has substantially different entry criteria, less recanalization and worse outcome.Conclusion: If untreated, 78% of patients with large vessel acute ischemic stroke will die or suffer long-term disabilities. Results suggest FIRST data could provide a benchmark for future thrombectomy trials. Study supported by: Penumbra, Inc.

AB - Background: Limited information is available on the natural history of the mechanical thrombectomy-eligible stroke cohort. Therefore, FIRST aims to collect real-world data in an appropriate population. Methods: The FIRST Trial is a prospective natural history study of a stroke cohort eligible for but untreated by endovascular therapy presenting with a large vessel occlusion and ineligible for or unresponsive to IV rtPA. The primary endpoint is 90-day mRS 0–2.Results: Sixty-one patients met analysis criteria. Mean age was 68; median NIHSS score was 18. Occlusions were in the ICA (28%), MCA (67%) and other (5%). The admission TIMI 0–1 rate was 98% and TICI 0–1 was 98%, in which10% and 12% spontaneously recanalized. Good 90-day out-come was achieved in 22%; 41% died, 54% had SAEs and 56% were IV rtPA-refractory. Compared to PROACT II, the FIRST cohort has substantially different entry criteria, less recanalization and worse outcome.Conclusion: If untreated, 78% of patients with large vessel acute ischemic stroke will die or suffer long-term disabilities. Results suggest FIRST data could provide a benchmark for future thrombectomy trials. Study supported by: Penumbra, Inc.

UR - https://onlinelibrary-wiley-com.libezproxy.dundee.ac.uk/toc/15318249/74/S17

M3 - Conference article

SN - 0364-5134

VL - 74

SP - S55-S55

JO - Annals of Neurology

JF - Annals of Neurology

IS - suppl 17

M1 - M1304

Y2 - 30 October 2013 through 2 November 2013

ER -

Poor natural history of large vessel acute ischemic stroke underscores the need for mechanical thrombectomy: natural history FIRST stroke study interim results

Abstract

Other files and links

Fingerprint

Cite this