371 Endovascular Thrombectomy for Posterior Cerebral Artery Occlusions: 30- and 90-Day Unplanned Readmissions in the United States

INTRODUCTION: While recent evidence has demonstrated the safety and efficacy of endovascular thrombectomy (EVT) for acute basilar artery occlusions, few studies have explored the benefit of EVT for posterior cerebral artery (PCA) occlusions. METHODS: The Nationwide Readmission Database years 2020 and 2021 was queried. Adult patients (>17 years old) undergoing EVT for PCA occlusions were identified using the ICD-10-CM coding system. Unique patient linkage numbers were used to follow patients and identify readmission rates. Patients were grouped by no readmission(Non-R), readmission within 30 days(30-R), and readmission within 31 to 90 days(90-R). The primary outcome was unplanned short-term readmission. RESULTS: We identified 737 admissions for PCA stroke (mean age, 69.3±13.6 years). Of these patients, 147 (19.9%) were readmitted (30-R:13.7%, 90-R:6.2%). There were no differences in the rates of tPA (30-R:38.8% vs. 90-R:25.8% vs. Non-R:29.6%,p=0.380) or NIHSS scores. During the index admission, there were no differences in the proportion of adverse events encountered by each cohort (30-R: 55.8% vs. 46.8% vs. 41.7%,p=0.191). The readmitted cohorts trended to have longer LOS [30-R:14 days, IQR (5-15) days vs. 90-R: 9 days, IQR (5-13) days vs. Non-R:7 days, IQR (4-15) days,p=0.056) and had more non-routine discharges (30-R: 66.7% vs. 90-R: 50.4% vs. Non-R:43.4%,p=0.003) compared to the non-readmitted cohort. The most common reasons for 30- and 90-day readmission were for diagnoses related to stroke syndromes or sequalae of cerebrovascular disease (30-R:8.9%, 90-R:22.5%) and cardiac diagnoses (30-R:9.8%, 90-R:24.3%). In the readmitted cohort, the all-cause inpatient mortality rate was 5.1%. CONCLUSIONS: This study explores the utilization and common reasons for readmission following EVT for PCA occlusions. Further study is warranted to corroborate these findings so as to help risk-stratify and improve the overall stroke care for these patients.