ABSTRACT NUMBER: ESOC2026A642 USE OF KNEE IMMOBILISERS TO REDUCE POST-THROMBECTOMY FEMORAL ACCESS SITE COMPLICATIONS

Abstract Background and aims Endovascular thrombectomy is the standard of care for patients presenting with an acute large vessel occlusion stroke who meet inclusion criteria. Femoral access site complications are common due to ipsilateral leg movement post-procedure leading to reopening of the arterial puncture site. There is lack of data regarding the optimal type of post-procedural limb immobilisation. Our aim was to evaluate for a change in groin complication rates before and after our institution implemented a change in practice in type of immobiliser. Methods This was a retrospective review of patients undergoing endovascular thrombectomy at a single comprehensive stroke center. Our institution’s practice of using soft ankle restraints ipsilateral to the femoral access site was replaced with orthopaedic knee immobilisers. Patient cases were compared between the year prior to the change (1 April 2023 to 31 March 2024) with greater than one year post-intervention (1 April 2024 to 5 October 2025). Groin site complication was defined as objective clinical and/or radiographic evidence of haemorrhage, site haematoma, and retroperitoneal haematoma developing after initial site compression and dressing. Results In the one year prior to the change in practice, 60 patients met inclusion criteria, of which 12 had femoral access site complications (20%). Following intervention, 74 patients met inclusion criteria, of which only 3 had complications (4.1%, p=0.004). Conclusions The use of knee immobilisers after mechanical thrombectomy for stroke was associated with a significant reduction in femoral access site complications compared to soft ankle restraints. Conflict of interest Christopher Gilbert: nothing to disclose. Jason Schick: nothing to disclose. Muhammad Farooq: nothing to disclose. Kasim Qureshi: nothing to disclose.