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

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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

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