ABSTRACT NUMBER: ESOC2026A1454 IMPACT OF ATRIAL FIBRILLATION AS AN ETIOLOGY OF ACUTE ISCHEMIC STROKE ON THE EFFECTIVENESS AND PROCEDURAL ASPECTS OF MECHANICAL THROMBECTOMY: A THROMBECTOMY-CAPABLE STROKE CENTER STUDY

Abstract Background and aims The duration and ease of the mechanical thrombectomy procedure in cases of large vessel occlusion (LVO) ischemic stroke significantly influence both radiological and clinical outcomes. This study aims to evaluate the impact of a cardioembolic source of thrombus in cases where atrial fibrillation is the etiology of stroke, on the procedural aspects of mechanical thrombectomy. Methods Retrospective single-centre study. Population of 306 patients, treated 2020-2025 - 243 patients qualified into analysis. Group divided: 1) patients with AF (140); 2) with other etiologies. Default treatment - SAVE (aspiration + stentretriever). Switching of the technique, time intervals recorded. Results measured: mTICI, NIHSS, mRS. Statistics - U Mann-Whitney for continuous, Chi-square for categorical. Results Population: AF as the etiology of LVO: older than no-AF (73.35 vs. 64.04yrs, p<0.001), females more (60% vs. 34.95%, p<0.001). Arterial hypertension greater (93.57% vs. 81.55%, p<0.05), rate of tobacco smoking lower (22.14% vs. 44.66%, p<0.001). NIHSS worse in AF (mean: 17.6 vs. 15.85, p<0.05). IVT lower (60% vs. 80.58%, p<0.01) -anticoagulation. Procedural: No differences observed between groups in time intervals: groin-to-first pass, first pass-to-recanalization; in the percentage of patients treated under GA. First-pass effect was higher in AF (52.14% vs. 35.29%, p<0.05), technique switching less frequent (19.29% vs. 30.39%, p<0.05). No differences in number of passes, balloon guide catheter, SAVE, ADAPT, stent retriever alone. No differences in complications. No differences in mTICI, NIHSS, mRS. Conclusions In patients with LVO caused by AF - higher rate of FPE, lower necessity for technique switching. No differences in complications, radiological, clinical outcomes compared to non-AF. Conflict of interest Artur Dziadkiewicz: nothing to disclose