Risultati per: Caratterizzazione dell'asma in base all'età di insorgenza: uno studio di coorte multi-database

‘Solo così troveremo personale per le aree più isolate’

Introduction
As a result of improving survival rates, the adverse consequences of rectal cancer surgery are becoming increasingly recognised. Low anterior resection syndrome (LARS) is one such consequence and describes a constellation of bowel symptoms after rectal cancer surgery which includes urgency, faecal incontinence, stool clustering and incomplete evacuation. LARS has a significant adverse impact on quality of life (QoL) and symptoms are present in up to 75% of patients in the first year after surgery. Despite this, little is known about the natural history and there is poor evidence to support current treatment options.

Methods and analysis
The objectives of POLARiS are to explore the natural history of LARS and to evaluate the clinical and cost-effectiveness of transanal irrigation (TAI) or sacral neuromodulation (SNM) compared with optimised conservative management (OCM) for people with major LARS.
POLARiS is a prospective, international, open-label, multi-arm, phase 3 randomised superiority trial within a cohort design, with internal pilot phase, qualitative sub-study, process evaluation and economic evaluation. Approximately 1500 adult participants from UK hospitals and 500 from Australian hospitals who have undergone a high or low anterior resection for colorectal cancer in the last 10 years will be recruited into the cohort. Six-hundred participants from the UK and 200 participants from Australia, with major LARS symptoms, defined as a LARS score of ≥30, will be recruited to the randomised controlled trial (RCT) element. Participants entering the RCT will be randomised between OCM, TAI or SNM, all with equal allocation ratios.
Cohort and RCT participants will be followed up for a 24-month period, completing a series of questionnaires measuring LARS symptoms and QoL, as well as clinical review for those in the RCT. A process evaluation, qualitative sub-study and economic evaluation will also be conducted.
The primary outcome measure of the POLARiS cohort and RCT is the LARS score up to 24 months post-registration/randomisation. Analyses of the RCT will be conducted on an intention-to-treat basis. Comparative effectiveness analyses for each endpoint will consist of two pairwise treatment comparisons: TAI versus OCM and SNM versus OCM. Secondary outcomes include health-related QoL, adverse events, treatment compliance and cost-effectiveness (up to 24 months post-registration/randomisation).

Ethics and dissemination
Ethical approval has been granted by Wales REC 4 (reference: 23/WA/0171) in the UK and Sydney Local Health District HREC (reference: 2023/ETH00749) in Australia. The results of this trial will be disseminated to participants on request and published on completion of the trial in a peer-reviewed journal and at international conferences.

Trial registration number
ISRCTN12834598; ACTRN12623001166662.

This survey study investigates the results of a multi-institutional clinical forensic dermatology training for residents.

Stroke, Volume 56, Issue Suppl_1, Page ATP304-ATP304, February 1, 2025. Introduction:Stroke is a common complication of infective endocarditis (IE), affecting 16–25% of cases, and can be the initial or sole manifestation of the condition. This study aims to analyze annual mortality trends and demographic factors related to stroke in IE patients in the U.S. and Texas from 1999 to 2020, to guide public health initiatives and enhance prevention strategies.Methods:The data was analyzed from the CDC’s WONDER database from 1999 to 2020, focusing on stroke and IE-related mortality (ICD-10 Code I64.0 “Stroke”&Code I33.0 “IE”) in adults aged ≥65 years, annual percent changes (APCs) in age-adjusted mortality rates (AAMRs) with 95% confidence intervals across various demographic (sex, race/ethnicity, age) subgroups was calculated.Results:The AAMR for stroke-related mortality in IE cases reduced in the US from an adjusted rate (AR) 448.7 in 1999 to 171.6 in 2018 (APC: -8.09%; 95% CI: -9.00% to -6.81%) and then it increased to 183.5 in 2020 (APC: 3.07%; 95% CI: 1.22% to 4.69%). In Texas, AAMR for stroke-associated IE-related mortality overall decreased from AR 485.7 in 1999 to 176.2 in 2020 (APC: -5.23%; 95% CI: -5.50% to -4.96%). Males had higher consistently higher AAMRs than females (196.4 vs. 172). The AAMR in the US men decreased from 468.6 in 1999 to 176.7 in 2018(APC: -7.55%; 95% CI: -8.51% to -6.21%), then it increased to 196.4 in 2020(APC: 4.99%; 95% CI: 2.93% to 6.81%). The AAMR in the US women decreased from 431.5 in 1999 to 165.6 in 2018(APC: -8.25%; 95% CI: -9.15% to -6.97%) after which it increased to 172 in 2020(APC: 1.48%; 95% CI: -0.31% to 3.06 %). The non-Hispanic (NH) Black or African American (AA) has the greatest AAMR (278.7), followed by the NH White with an AAMR (179) and the NH American Indian or Alaska Native population with an AAMR (165.4). The low-risk populations were the Hispanic or Latino (143.6) and the NH Asian or Pacific Islander (135.2). AAMR also varied by region (overall AAMR: Midwest: 200.8; South: 193.9; Northeast: 166.2; West: 162.8) and non-metropolitan areas had higher AAMR (non-core areas: 233.4; micropolitan areas: 224.5) than metropolitan areas (large fringe metro areas: 170.5; large central metropolitan areas:160.4).Conclusions:The stroke-related mortality in infective endocarditis cases has overall risen in the United States than in Texas over the past two decades, specifically men and (NH) Black or AA, (NH) White and (NH) American Indian or Alaska Native are at high risk.

Stroke, Volume 56, Issue Suppl_1, Page ATMP69-ATMP69, February 1, 2025. Introduction:Cerebral Amyloid Angiopathy (CAA) is caused by the progressive deposition of β-amyloid in the walls of small to medium-sized cerebral vessels. Although seizures represent a debilitating manifestation of CAA, little is known about their prevalence or associated factors. We aim to fill this gap by determining the prevalence of seizures in CAA and identify factors associated with an increased risk of seizures.Methods:We identified consecutive patients with CAA, evaluated within the Mayo Clinic health system between January 2010 and December 2023 using the ICD-10 code. Data on demographics and comorbidities were compared between those with and without seizures using the chi-square test for categorical variables and independent samples t-test for continuous variables. Odds ratios (OR) were estimated after adjusting for age, sex, and race in multivariable logistic regression.Results:We included 1,914 patients with CAA with a mean age of 75.4 ± 8.6 years, of whom 52.3% were female and 87.5% were white. Seizures were observed in 347 patients (18.1%). Individuals with seizures were significantly younger (mean age 67.7 ± 9.1 vs. 77.2 ± 7.5 years, p < 0.001). Multivariable modeling identified alcohol abuse (OR 1.92, 95% CI 1.03-3.56, p=0.04), diabetes mellitus (OR 2.14, 95% CI 1.13-4.06, p=0.02), hypertension (OR 1.79, 95% CI 1.33 - 2.41, p=

Stroke, Volume 56, Issue Suppl_1, Page ATMP84-ATMP84, February 1, 2025. Introduction:Complete reperfusion (TICI 2c/3) with the fewest number of passes remains the target for EVT techniques, but at present, rates remain relatively low. Prior studies have demonstrated that switching techniques between passes may improve rates of reperfusion. Here we assess the efficacy of technique switching after the first pass failed reperfusion in a large multi-center cohort.Methods:All consecutive patients treated with EVT from 12 centers across the US were prospectively collected between 10/2018 – 12/2021 (SVIN Registry). Patients were included if they underwent EVT for occlusion of the M1 or ICA-T. Exclusion criteria included incomplete data. EVT technique was categorized as Stent-Retriever (SR), Contact Aspiration (CA), or a Combined Technique (CT). The primary outcome was the likelihood of achieving TICI 2c/3 with or without switching the thrombectomy technique and was determined using multivariable logistic regression adjusted for the use of balloon guide catheter, occlusion location, age, and co-morbid medical conditions.Results:Among 2,891 patients in the SVIN registry included in this analysis, the median age was 69 years [IQR, 58-80], 49.9% were female and median NIHSS was 17 [IQR, 12-22]. Occlusion location was ICA-T in 18.4% and M1 in 81.6%. As shown in Figure 1a, for patients with ICA-T occlusions, first-pass TICI 2c/3 occurred in 32.7% with SR, 23% with CA, and 31.2% with CT. As shown in Figure 1b, for patients with M1 occlusions, first-pass TICI 2c/3 occurred in 37.7% with SR, 35.9% with CA, and 35.4% with CT. Switching from CA to SR or CT for the 2nd pass was associated with increased point estimates of 2nd pass TICI 2c/3 for patients with ICA-T occlusions (27% vs 12%, second pass SR vs. second pass CA, p=0.06). In multivariable logistic regression, odds of TICI 2c/3 were significantly greater (OR 3.7, CI 95% [1.1 – 12.4]) after switching to SR or CT after a failed first pass with CA in patients with ICA-T occlusion.Conclusions:Switching from CA to SR-based techniques was associated with improvement in TICI 2c/3 reperfusion rates among patients with Internal Carotid Artery Terminus occlusions.

Stroke, Volume 56, Issue Suppl_1, Page ATP163-ATP163, February 1, 2025. Introduction:Imaging features are increasingly relevant for predicting response to endovascular treatment in acute ischemic stroke (AIS) patients. Collateral status is a well-documented marker of reperfusion and mortality in patients with large vessel occlusion (LVO) anterior circulation strokes, which account for approximately one-third of AIS. There is ongoing investigation into optimal collateral status determination, with single and multiphase computed tomography angiography (mCTA) and CT perfusion parameters under consideration. To assess the utility of these parameters, we evaluated their association with the American Society of Interventional and Therapeutic Neuroradiology (ASITN) collateral score standard on digital subtraction angiography (DSA).Methods:We retrospectively evaluated AIS patients treated at our institution between January 2017 and January 2023. Inclusion criteria were: (i) CTA-confirmed anterior circulation LVO; (ii) diagnostic CT perfusion was performed; (iii) mechanical thrombectomy was attempted with documented DSA collateral score. Modified Treatment in Cerebral Ischemia (mTICI) score was used to determine reperfusion status, with mTICI > 2b considered successful. Univariate and multivariate logistic regression analyses were conducted to determine associations of demographic/clinical factors and collateral status with ASITN and reperfusion status.Results:A total of 311 patients (mean age 67.35 ± 16.37, 57.4% female) met inclusion criteria. On univariate analysis, PM2 occlusion site (p=9.78E-7), Alberta Stroke Programme Early CT Score (p=0.006), mCTA (p=1.82E-10), cortical vein opacification score (p=4.18E-7), and clot burden score (CBS, p=3.01E-13) were associated with ASITN score of three or greater, signifying complete collateral flow. On multivariate regression adjusted for race, occlusion site, radiologic features, and admission NIH stroke score, PM2 occlusion site (aOR 1.19, p=0.049), mCTA (aOR 3.59, p=6.03E-5), and CBS (aOR 1.37, p=0.03) were associated with ASITN ≥ 3 (Table 1). No radiologic features were associated with successful reperfusion (Table 2).Conclusion:Multiphase CTA and clot burden score show a stronger association with favorable DSA collateral scores than do CT perfusion parameters, including cerebral blood volume and hypoperfusion intensity ratio. Further studies are needed to evaluate these measures in outcome prediction to aid clinical decision-making for AIS patients with anterior circulation LVOs.

Stroke, Volume 56, Issue Suppl_1, Page A22-A22, February 1, 2025. Introduction:Though clinical practice guidelines support high repetitions of walking after stroke, practice is slow to change with low levels of walking activity in stroke rehabilitation units. We undertook an implementation trial to change practice; we enabled entire stroke units to use the Walk ‘n Watch protocol and determined the effect of implementation on the 6 Minute Walk Test (6MWT) at hospital discharge.Methods:This 12-site clinical trial across 7 Canadian provinces used a stepped-wedge cluster design to randomize when each site switched from Usual Care to the Walk ‘n Watch protocol. At the start of the Walk ‘n Watch phase, we trained all front-line physical therapists on the unit with training workshops, manuals, hands-on practice, and videos. Each site was provided onboarding materials to address staff changes so therapists who did not attend the initial training could adopt the protocol. Each site also identified a ‘protocol champion’ to facilitate initial weekly huddles with therapists to discuss barriers to implementation. Therapists were trained to complete safety screening and to determine eligibility. The Walk ‘n Watch protocol focused on completing a minimum of 30-minutes of daily weight-bearing, walking-related activities that progressively increased in intensity informed by activity trackers measuring heart rate and step number. Blinded assessors completed the outcomes at baseline and 4-weeks later (near discharge). Primary analysis used a linear mixed-effects model adjusted for stratum, date of enrollment, age, sex and baseline 6MWT.Results:The total number of participants was 306 (162 Usual Care, 144 Walk ‘n Watch, 188 males/118 females) with a mean(SD) age of 68(13), 29(17) days since stroke, and a baseline 6MWT of 152(106) m. The improvement on the 6MWT was 43.6m (95%CI 12.7, 76.1) greater in the Walk ‘n Watch group compared to the Usual Care group. Further, the Walk ‘n Watch group improved quality of life (EQ5D), balance and mobility (Short Physical Performance Battery) and gait speed.Conclusions:The implementation trial design enabled the protocol to be tested under real-world conditions, involving all therapists on each unit to deliver the protocol. The trial had a deliberate aim to facilitate changes in practice that resulted in clinically meaningful improvements in walking and quality of life.

Stroke, Volume 56, Issue Suppl_1, Page ATP142-ATP142, February 1, 2025. Introduction:Coronary atherosclerotic disease (CAD) carries the highest risk of recurrent stroke, up to 15% annually, and individuals with coronary heart disease are twice as likely to have a stroke. This study aims to analyze annual mortality trends and sociodemographic factors related to stroke in CAD patients in the U.S. and Texas from 1999 to 2020, to inform public health policies.Methods:Using the CDC’s WONDER database from 1999 to 2020, focusing on stroke and CAD-related mortality(ICD-10 code I64.0 “Stroke”&Code I25.1 “Atherosclerotic heart disease ”) in adults aged ≥45 years, annual percent changes(APCs) in age-adjusted mortality rates (AAMRs) with 95% confidence intervals across various demographic (sex, race/ethnicity, age) subgroups were calculated.Results:The AAMR for stroke-related mortality in CAD cases reduced in the US from an adjusted rate(AR) 174.5 in 1999 to 105.2 in 2009(APC: 5.48%; 95% CI: -6.09% to -5.24%) after which it reduced further to 69.4 in 2018(APC: -7.87%; 95% CI: -8.77% to -6.53%) then it increased to 75.9 in 2020(APC: 4.38%; 95% CI: 2.63% to 5.88%). In Texas, AAMR for stroke-associated CAD-related mortality overall decreased from AR 189.7 in 1999 to 73.5 in 2020(APC: -4.96%; 95% CI: -5.27% to -4.66%). Males had higher consistently higher AAMRs than females (83 vs. 69.5). The AAMR in the US men decreased from 183.7 in 1999 to 72.9 in 2018(APC: -7.23%; 95% CI: -8.22% to -5.92%), then it increased to 83 in 2020(APC: 6.40%; 95% CI: 4.31% to 8.19%). The AAMR in the US women decreased from 166.3 in 1999 to 65.7 in 2018(APC: -7.89%; 95% CI: -8.79% to -6.63%) after which it increased to 69.5 in 2020(APC: 2.38%; 95% CI: 0.49% to 4.06 %). The non-Hispanic (NH) Black or African American (AA) has the greatest AAMR (122), followed by the NH American Indian or Alaska Native with an AAMR (76.8) and the NH White population with an AAMR (72.9). The low-risk populations were the Hispanic or Latino (58.8) and the NH Asian or Pacific Islander (54.2). AAMR also varied by region (overall AAMR: Midwest: 82.1; South:82; Northeast:67.1; West:66.4)&non-metropolitan areas had higher AAMR (non-core areas:98.5; micropolitan areas:94) than metropolitan areas (large fringe areas:69.3; large central metropolitan areas:66.7).Conclusions:The stroke-related mortality in CAD cases has overall risen in the US compared to Texas over the past two decades, specifically men and (NH) Black or AA, (NH) American Indian or Alaska Native and (NH) White are at high risk.

Stroke, Volume 56, Issue Suppl_1, Page ATP389-ATP389, February 1, 2025. Background:The variations in stroke volume are large and behavioral deficits are short-lived in rodent stroke models. These issues pose a challenge when using a rodent stroke model to test therapeutic interventions. The objective of this study is to explore composite analysis of multi-category behavioral outcomes for increasing the drug testing utility of the mouse middle cerebral artery occlusion (MCAO) model.Methods:Mice were subjected to 0 (sham), 20, 40, and 60 min MCAO, followed by 21 days of recovery. The rCBF was maintained at

Stroke, Volume 56, Issue Suppl_1, Page AWMP59-AWMP59, February 1, 2025. Background and Purpose:External counterpulsation (ECP) is a novel noninvasive method used to improve the perfusion of vital organs, which may benefit ischemic stroke patients. We aimed to test the hypothesis that ECP may improve disability in addition to best medical treatment in atherosclerotic stroke patients within 7 days of symptom onset.Methods:The trial was a multi-centre, randomized, controlled trial. Patients with cerebral large artery occlusive disease were randomized to 35 one-hour sessions of ECP group or no-ECP control group, in addition to best available evidence-based medical and rehabilitation treatment. Primary outcome was modified Rankin scale (mRS) grade at month 3, defined as a good outcome with a mRS≦2. Secondary outcomes were the scores of National Institutes of Health Stroke Scale (NIHSS) and Barthel index (BI), stroke recurrence, overall mortality and the occurrence of vascular events by 3 months (recurrent stroke, acute coronary syndrome, deep vein thrombosis and hemorrhagic transformation or intracerebral hemorrhage).Results:In the randomized 189 patients from three hospitals, totally 5 patients were lost to follow-up at month 3. Therefore, 184 patients (97.4%) with moderate neurological deficit (mean NIHSS, 8.2) were included into the intention-to-treat analysis (90 ones in ECP group and 94 ones in No-ECP group, respectively). The groups were balanced in all demographic data. At month 3, there were no significant differences in the proportion of patients with good outcome (ECP 42.2% vs no-ECP 35.1%, P=0.322) and the secondary outcomes, except the incidence of vascular events with a favorable trend (ECP 3.3% vs no-ECP 8.5%, P=0.139). After adjusting for the factors not complying with trail design, a significant lower incidence of vascular events was found in 0.0% of 65 patients in ECP group compared to 9.1% of 88 patients in no-ECP group (P=0.021) at month 3 in per-protocol analysis.Conclusion:ECP did not statistically significantly improve disability in atherosclerotic stroke within 7 days of symptom onset in the RCT trial. However, per-protocol analysis showed that completion of total 35 one-hour sessions of ECP treatment is beneficial for reducing the incidence of new vascular events in atherosclerotic stroke after 3 months of onset.Registration number: ChiCTR-TRC-07000706

Stroke, Volume 56, Issue Suppl_1, Page AWP331-AWP331, February 1, 2025. Introduction:Stroke is the second leading cause of death worldwide,around 50,000 U.S. residents with valvular heart disease experiencing a stroke annually. This study examines trends in stroke-related mortality due to mitral valve disorders (MVD) in the U.S. from 1999 to 2020, with a focus on demographic factors and racial disparities. The goal is to inform public health strategies and improve prevention and treatment efforts.Methods:We analyzed death certificate data from the CDC’s WONDER database from 1999 to 2020, focusing on stroke and MVD-related mortality (ICD-10 code I64.0 “Stroke” and Code I34.0 “MVD”) in adults aged ≥25 years. Using joint point regression analysis, we calculated annual percent changes (APCs) in age-adjusted mortality rates (AAMRs) with 95% confidence intervals across various demographic (sex,race/ethnicity,age) subgroups.Results:The AAMR for stroke due to MVD-related mortality decreased in the US from an adjusted rate (AR) 98.6 in 1999 to 92.9 in 2001 (APC: -2.64%; 95% CI: -4.18% to -1.35%),after which it decreased to 59.6 in 2009 (APC: -5.47%; 95% CI: -6.20% to -5.19%) then it further reduced to 50.1 in 2015 (APC: -2.84%; 95% CI: -3.27% to -1.78%).The AAMR decreased in 2018 to 40.2 (APC: -7.28%; 95% CI: -8.08% to -6.22%) after which it increased to 43.9 in 2020 (APC: 4.15%; 95% CI: 2.56% to 5.59%). Males had higher consistently higher AAMRs than females (47.8 vs. 40.3).The AAMR in the US men decreased from 103.6 in 1999 to 51.5 in 2015 (APC: -2.62%; 95% CI: -3.04% to -1.49%) after which it decreased further to 42.2 in 2018 (APC: -6.75%; 95% CI: -7.72% to -5.48%)&then it increased to 47.8 in 2020 (APC: 6.11%; 95% CI: 4.10% to 7.85%).The AAMR in the US women decreased from 94.1 in 1999 to 48.3 in 2015 (APC: -3.05%; 95% CI: -3.51% to -1.75%) after which it decreased further to 38.2 in 2018 (APC: -7.57%; 95% CI: -8.81% to -6.18%) and then it increased to 40.3 in 2020 (APC: 2.32%; 95% CI: -0.26% to 4.49%).The non-Hispanic (NH) Black or African American (AA) has the greatest AAMR (69.2), followed by the NH American Indian or Alaska Native with an AAMR (44.2) and the NH White population with an AAMR (42.4).The low-risk populations were the Hispanic or Latino (33.6) and the NH Asian or Pacific Islander(31).Conclusions:The mortality rates from stroke due to MVD have overall increased in the United States over the past two decades, specifically men&(NH) Black or AA, NH American Indian or Alaska Native, and (NH) White are at high risk.

Stroke, Volume 56, Issue Suppl_1, Page AWP133-AWP133, February 1, 2025. Background:Ischemic thalamic stroke often leads to cognitive and emotional dysfunctions, yet the link between these deficits and structural brain changes remains unclear. This study explores the association between gray matter volume alterations and neuropsychological assessments in ischemic thalamic stroke patients, aiming to elucidate the structural basis of neuropsychiatric deficits.Methods:Patients with first-time unilateral ischemic thalamic stroke were recruited from West China Hospital, Sichuan University (October 2021 – December 2023). Inclusion criteria included MRI-confirmed diagnosis, subacute phase (7 days to 1 month), completion of cognitive and structural MRI evaluations, and informed consent. MRI scans were processed using CAT12 and SPM12. Cognitive assessments included MoCA-BJ, STT, Stroop, and CAVLT tests; psychological status was evaluated using HAMA and HAMD scales. Partial Least Squares (PLS) regression analyzed the relationship between gray matter volume (170 ROIs) and neuropsychological scores (11 indicators). Data were standardized, with the optimal number of components determined by MSE using 5-fold cross-validation. Model performance was assessed using R2.Results:PLS regression revealed significant associations between gray matter volume and neuropsychological outcomes. The optimal number of components was determined to be two through 5-fold cross-validation, with the model showing good fit as indicated by the R2 and residual plots. Specific brain regions, including the Left Inferior Parietal Gyrus (lIPG), Right Cerebellar Lobule VI (rCER6), and Right Cerebellar Crus I (rCERCRU1), were significantly associated with cognitive and emotional assessment scores. VIP scores and loading matrix analyses highlighted these regions as key areas.Conclusions:This study, using PLS regression, identifies significant relationships between gray matter volume changes and neuropsychological assessments in ischemic thalamic stroke patients. Key regions such as lIPG, rCER6, and rCERCRU1 are closely linked to cognitive and emotional functions, including attention, spatial cognition, memory, and emotional regulation. These findings provide critical insights into the structural basis of neuropsychiatric deficits post-stroke and support the development of personalized rehabilitation strategies. Future research should validate these regions’ roles across rehabilitation stages and explore targeted interventions.

Stroke, Volume 56, Issue Suppl_1, Page ATP273-ATP273, February 1, 2025. Introduction:Patients suffering from transient ischemic attack (TIA) are at high risk of ischemic stroke (IS). This study describes clinical characteristics and outcomes in patients with a first non-cardioembolic TIA.Methods:Using two US administrative claims databases (MarketScan and Optum’s de-identified Clinformatics® Data Mart Database [CDM]) converted to the Observational Medical Outcomes Partnership (OMOP) common data model, we conducted an observational, retrospective cohort study of adults with a first diagnosis of non-cardioembolic TIA between 2012 and 2022. Demographic and clinical characteristics were described at baseline, and incidence rates of IS, intracranial bleeding, and bleeding leading to hospitalization with sensitivity analyses at different time points were calculated.Results:Overall, 203,757 patients were included in the study, 97,481 from MarketScan, 106,276 from CDM. Mean age was 62 years in MarketScan and 72 years in CDM. Patients were mostly women (57.6% in MarketScan, 59.3% in CDM). At baseline, prevalence of comorbidities was high (hypertension 66% and 84%, hyperlipidemia 53% and 75%, coronary artery disease 18% and 31%, diabetes 25% and 38% in MarketScan and CDM, respectively). Median follow-up time was 569 days in MarketScan and 716 days in CDM. At 1 year follow-up, incidence rates per 100 person-years of IS, intracranial bleeding, and bleeding leading to hospitalization were 10.9, 0.9, and 4.2, respectively, in MarketScan and 20.2, 1.6, and 7.6 respectively, in CDM. Sensitivity analyses showed that most IS events occurred within 7 days of the index event. Additional event rates and sensitivity analyses are shown in Table 1.Conclusion:Results from two US claims databases show that the annual risk of IS is higher than expected following a first TIA diagnosis, especially when including the first 7 days in the ascertainment. Implementation of guideline directed antiplatelet therapies, or new antithrombotic strategies, is needed.

Stroke, Volume 56, Issue Suppl_1, Page ATP239-ATP239, February 1, 2025. Background:There are limited therapy options in case of failed reperfusion after stent-retriever and/or aspiration based endovascular treatment (EVT) for acute ischemic stroke. Despite the absence of data supporting its use, rescue angioplasty (RA; with or without stent implantation) is often utilized in such cases. Studies are limited to large vessel occlusions, while the outcomes and complications after RA in medium/distal vessel occlusions (MDVOs) have not been reported. This study aims to report the outcomes of RA in MDVO stroke patients.Methods:We performed a retrospective sub-analysis of the “Blood pressure and Antiplatelet medication management after reScue angioplasty after failed Endovascular treatment in Large and distal vessel occlusions with probable IntraCranial Atherosclerotic Disease” (BASEL ICAD) registry. All MDVO stroke patients were included in the analysis.Results:Out of 718 patients, 92 (12.8%) presented with an MDVO. Sixty-one patients (65.9%) presented with an occlusion of the M2 segment of the middle cerebral artery. Rescue stenting (RS) was performed in 83 patients (90.2%) and balloon angioplasty alone was performed in 9 patients (9.8%). Successful reperfusion (modified thrombolysis in cerebral infarction (mTICI) score ≥ 2b) before RA was achieved in 34 patients (36.9%) and after RA in 76 (82.6%) patients. Symptomatic intracranial hemorrhage (sICH) occurred in 8 patients (9.1%) and post-treatment stent occlusion in 14 patients (16.7%). 90 days mortality was 24.1%. Twenty-nine patients (34.9%) achieved functional independence at 90 days (modified Rankin Scale 0 – 2).Conclusion:Rescue Angioplasty might be a viable treatment option in case of failed reperfusion after conventional EVT in selected MDVO patients. However, safety concerns remain.

Stroke, Volume 56, Issue Suppl_1, Page ATP281-ATP281, February 1, 2025. Introduction:We assess the risk of stroke in individuals with and without a migraine diagnosis, adjusting for demographic variables and stroke risk factors using participant information from the All of Us database.Method:Diagnoses of migraine, stroke and comorbidities were identified using ICD9 and ICD10 codes. A multivariable logistic regression analysis was performed to assess the association between migraine and risk of stroke adjusting for comorbidities including hypertension, atrial fibrillation, hyperlipidemia, diabetes, tobacco use, depression and demographics (age, sex at birth, race and ethnicity). To compare the prevalence of stroke between individuals with and without migraine, odds ratios using a 95% confidence interval (CI) were calculated.Results:Within theAll of Usdatabase, 31,444 individuals received a migraine diagnosis (female=25,374/81%, male=5,391/17%, other=679/2%; mean (std) age=54.9 (15.6)) and 379,283 did not have a migraine diagnosis (female=222,104/59%, male=149,182/39%, other=7,997/2%; mean (SD) age=55.9 (17.2)), see Figure 1 for detailed demographics.The migraine cohort had a greater proportion of women (81% vs 59%, p