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Introduction: Endovascular Therapy (ET) has become the new standard of care for treating acute ischemic stroke (AIS) patients with Emergent Large Vessel Occlusion (ELVO). There are numerous tools that predict outcomes of ischemic stroke patients including those given IV tPA, however, there are no published tools for predicting outcomes after ET. Methods: From January 2015-March 2017, 109 AIS patients received ET. Patients with unsuccessful ET (TICI 0-2a) or with incomplete 90 day follow-up data were excluded, leaving 42 for final analysis. Primary outcome was defined as MRS at 90 days (good outcome MRS <=3, bad outcome MRS >3). Of the variables analyzed, 90 day outcomes correlated with age, diabetes, thrombolytic use, onset to groin time, and NIHSS scores. Numerical values were assigned to each variable based on OR analysis and the resulting score (range 0-8) was plotted against 90 day MRS and ROC analysis defined a cutoff value. Results: The relative score for each non-binary variable was approximated based on the corresponding OR identified during ROC analysis. Using the DamAGE cONTrol scoring tool (figure 1), a cut off of 4 points yielded Sn 0.82, Sp 0.95, p <0.001, & AUC 0.94 . Conclusion: DamAGE cONTrol represents a novel scoring tool which uses pre-intervention characteristics to predict outcome after successful ET. This type of tool may facilitate more informed discussions regarding the value of performing ET, as well as control unnecessary transfers.

Introduction: The importance of blood pressure control after IV tPA is well known. Current practice is to use these same parameters for patients undergoing Endovascular Thrombectomy (ET). However, optimal blood pressure control following ET is not well defined, the DAWN trial used a target of <140mmHg in their study population and there is retrospective evidence that a target of <160mmHg is associated with good outcomes. Herein, we provide retrospective evidence in regards to likelihood of good outcomes based on relative SBP control after successful ET. Methods: A retrospective analysis of patients who underwent ET was conducted from January 2017 to April 2018 yielding 92 patients; those with unsuccessful recanalization or incomplete data were excluded leaving 51 for final analysis. Patients were dichotomized in two groups based on good (mRS ≤ 2) and bad (mRS ≥3) outcomes. We performed an ROC analysis to determine the percentage of time that SBP exceeded 140mmHg in order to be associated with a poor outcome at 90 days. Results: ROC analysis found that when 45% of SBP readings exceeded 140mmHg, there was a poor outcome at 90 days with sensitivity and specificity of 61 and 82%, respectively. The AUC of this analysis was 0.71 with a p-value of <0.05. The PPV and NPV for this cutoff were 80% and 66%, respectively. Conclusion: The percentage of time that SBP exceeds the target of 140mmHg in the first 24 hours appears to have an independent correlation with outcome in patients after successful ET. Those patients with uncontrolled SBP, defined as SBP >140mmHg 45% of the time or more experienced a poor outcome in 80% of cases. Those patients with controlled SBP, defined as <140mmHg 55% of the time or more experienced a good outcome in 82% of cases. Our study has obvious limitations due to the retrospective nature of the study and small sample size. While the values we studied for SBP control do not represent the continuously variable nature of this parameter, they do represent a general trend and are compatible with the standard of care seen amongst facilities providing ET. A randomized controlled trial to study these findings could have great implications to current practice.