Mechanical Thrombectomy in Patients with Acute Ischemic Stroke on Anticoagulation Therapy
Language English Country United States Media print-electronic
Document type Journal Article
PubMed
29450625
DOI
10.1007/s00270-018-1902-7
PII: 10.1007/s00270-018-1902-7
Knihovny.cz E-resources
- Keywords
- Anticoagulation therapy, Clinical outcome, Ischemic stroke, Mechanical thrombectomy, Symptomatic intracerebral hemorrhage,
- MeSH
- Anticoagulants therapeutic use MeSH
- Stroke surgery MeSH
- Brain Ischemia surgery MeSH
- Humans MeSH
- Retrospective Studies MeSH
- Aged MeSH
- Thrombectomy methods MeSH
- Treatment Outcome MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Names of Substances
- Anticoagulants MeSH
INTRODUCTION/PURPOSE: Mechanical thrombectomy (MT) for acute ischemic stroke (IS) can be performed also in patients on anticoagulation therapy (AT); however, sufficient and reliable data about safety and efficacy of MT are still missing. Thus, we aimed to compare these parameters between patients treated on AT and without AT. MATERIALS AND METHODS: All consecutive IS patients treated with MT using stent retrievers were included in the retrospective analysis. Neurological deficit was scored using National Institutes of Health Stroke Scale (NIHSS) and 90-day clinical outcome using modified Rankin scale with a score 0-2 for good outcome. Recanalization was rated using Thrombolysis in Cerebral Infarction (TICI) scale. Symptomatic intracerebral hemorrhage (SICH) was assessed according to the SITS-MOST criteria. RESULTS: Out of 703 patients treated with MT, 88 (12.5%) patients (46% males, mean age 75.5 ± 11.8 years) were on AT with an admission median NIHSS of 17 points. Recanalization (TICI 2b-3) was achieved in 80% and complete (TICI 3) in 65% of patients on AT and in 80 and 65% of patients without AT (p-1.000). SICH after MT was detected in 9% of AT and 5% of non-AT patients (p-0.136). Good outcome was present in 36% of AT patients (p-0.03). AT patients with poor outcome had more frequently atrial fibrillation (93%, p-0.005), higher admission NIHSS (17, p-0.004) and higher rate of SICH (14.5%, p-0.047). CONCLUSION: MT seems to be safe also in patients on AT. Poor outcome may be related to higher admission NIHSS, higher rate of SICH and presence of atrial fibrillation.
Department of Emergency Masaryk Hospital Ústí nad Labem KZ a s Ústí nad Labem Czech Republic
Department of Radiology Masaryk Hospital Ústí nad Labem KZ a s Ústí nad Labem Czech Republic
Department of Radiology Palacký University Medical School and Hospital Olomouc Czech Republic
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