ABSTRACT NUMBER: ESOC2026A731 REPEATED MECHANICAL THROMBECTOMY IN RECURRENT LARGE VESSEL OCCLUSION STROKE

Abstract Background and aims Mechanical thrombectomy (MT) is the standard of care for large vessel occlusion (LVO) stroke. However, the frequency, cause and outcomes of repeated thrombectomy (rMT) for recurrent LVO is less clear. We aimed to evaluate the efficacy of rMT for recurrent LVO stroke. Methods Of 887 MT patients in this single centre experience within 6 years, 19 went rMT with an overall prevalence of 2,1% and a mean age of 69, 84 ± 13,35 years. Results The median time interval between thrombectomies was 17.76 days and 6 of 19 patients (31%) had rMT during first hospitalization. Twelve patients (63%) experienced rLVO of a same artery. For rLVO, FA with cardioembolic stroke was the most common etiology (68%), followed by ICAD (16%) and dissection (16%). Successful reperfusion was recorded in 89% after the first MT and in 84% patients after the second MT. Four patients had received rescue intra or extracranial stenting. Eleven patients had anticoagulation and nine antiaggregation therapy prescribed after 1st MT. Although the mean NIHSS score before second MT was higher (12,84±3,94), NIHSS after 1st (5,58 ± 5,54) and 2nd (9,11 ± 5,51) MT did not significantly differ (p<0,05). Functional independence after rMT defined as modified Rankin scale of 0-2 was achieved in 42% patients at three months follow-up. Conclusions Around 2% of patients after MT will experience rLVO and rMT, mostly in same artery after 1st MT with FA as main risk factor. Repeated MT appears to be safe and effective with good outcome comparable as those who undergo single thrombectomy. Conflict of interest Mislav Budisic: Nothing to disclose