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.
|Number of pages||1|
|Journal||Annals of Neurology|
|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