{
  "abstract": "Introduction/Purpose While there has been a general trend toward national decline in stroke mortality due to advances in stroke care management, the relatively increased stroke mortality in the South/Midwestern United States (colloquially named the ‘stroke belt’) persists. To date, there has been no objective analysis of key characteristics of young stroke patients who meet mechanical thrombectomy criteria and undergo intervention in the stroke belt, despite evidence of a significant increase in incidence among younger demographics (15-49 years), notably in Arkansas, even compared to surrounding states.Materials and Methods 76 patients younger than age 50 who underwent mechanical thrombectomy at our institution from February 2015 to August 2025 were identified. Key demographics (age, gender, race), clinical presentation characteristics (transfer from outside hospital, NIHSS on arrival and at 24 hours), timing of care (duration to puncture, procedural duration, etc.), radiographic stroke and procedural characteristics (location, core, mismatch, ASPECTS, TICI reperfusion, need for stenting), relevant medical comorbidities, information regarding underlying etiology, and mortality rates were collected for statistical analysis. Statistical analysis involving the Wilcoxon rank-sum, Kruskal-Wallis test, Fisher’s exact test, Spearman correlation, Mann-Whitney U test, and Chi-squared test was used where appropriate.Results While women and Caucasians had the highest incidence of young stroke in our sample, there was no statistically significant difference among any demographic groups affected by young stroke in patients who met thrombectomy criteria. Females were more likely to present with lower CT ASPECTS scores (p-value = 0.024). Females had a significantly longer interval from the last known well time to the puncture time (p-value = 0.0414). Patients with ICA occlusions had a significantly higher mortality rate of 35% (p-value = 0.0025), while patients with MCA strokes had the lowest mortality risk, with a rate of 0% in our sample (p-value <0.0001). An underlying coagulopathy was significantly more likely in patients presenting with a posterior circulation stroke (p-value = 0.037). Patients who required concomitant stenting tended to have lower ASPECTS scores (p-value = 0.0288), higher NIHSS on arrival (p-value = 0.0058), and higher NIHSS at 24 hours (p-value = 0.0393).Conclusion While the advent of mechanical thrombectomy has significantly improved outcomes in the treatment of acute stroke, the incidence among young individuals continues to rise for reasons that remain unclear. Here, we describe the typical presentation of these patients at our hospital and highlight the widespread nature of the disease, with no clear preference for specific demographics. Although younger patients tend to have better outcomes than the elderly, our study underscores the severe impact of ICA occlusion regardless of recanalization, as 90% of young stroke patients with ICA occlusion at our institution achieved a satisfactory TICI recanalization grade (defined as grade 2B or better in previous literature). Our analysis reinforces the urgent need for rapid access to centers capable of providing endovascular intervention. Further research is necessary to develop strategies to ensure swift delivery of mechanical thrombectomy to these patients, as this is closely linked to outcomes in this growing patient population.Disclosures A. Rezayev: None. A. McClanahan: None. M. Walker: None. J. Tilford: None. S. Onteddu: None. K. Nalleballe: None. J. Morales: None. A. Mohamed: None. D. Sasaki-Adams: None. S. Patro: None.",
  "authors": [
    {
      "affiliations": [
        "Neurosurgery, University of Arkansas for Medical Sciences, Little Rock, AR"
      ],
      "name": "A Rezayev"
    },
    {
      "affiliations": [
        "Radiology, University of Arkansas for Medical Sciences, Little Rock, AR"
      ],
      "name": "A McClanahan"
    },
    {
      "affiliations": [
        "Statistics, University of Arkansas for Medical Sciences, Little Rock, AR"
      ],
      "name": "M Walker"
    },
    {
      "affiliations": [
        "Statistics, University of Arkansas for Medical Sciences, Little Rock, AR"
      ],
      "name": "J Tilford"
    },
    {
      "affiliations": [
        "Neurology, University of Arkansas for Medical Sciences, Little Rock, AR"
      ],
      "name": "S Onteddu"
    },
    {
      "affiliations": [
        "Neurology, University of Arkansas for Medical Sciences, Little Rock, AR"
      ],
      "name": "K Nalleballe"
    },
    {
      "affiliations": [
        "Neurointerventional Radiology, University of Arkansas for Medical Sciences, Little Rock, AR"
      ],
      "name": "J Morales"
    },
    {
      "affiliations": [
        "Neurointerventional Radiology, University of Arkansas for Medical Sciences, Little Rock, AR"
      ],
      "name": "A Mohamed"
    },
    {
      "affiliations": [
        "Neurosurgery, University of Arkansas for Medical Sciences, Little Rock, AR"
      ],
      "name": "D Sasaki-Adams"
    },
    {
      "affiliations": [
        "Neurointerventional Radiology, University of Arkansas for Medical Sciences, Little Rock, AR"
      ],
      "name": "S Patro"
    }
  ],
  "title": "E-291 Analysis of young stroke patients who underwent mechanical thrombectomy in the United States ‘stroke belt’",
  "uid": "b7e83857-5199-5f18-b949-c95acd6431b3"
}