How does the use of antiplatelet and anticoagulants affect the success of mechanical thrombectomy in acute ischemic stroke cases?

ABSTRACT

Background and purpose: In this study, we wanted to investigate the effect of antiplatelet and anticoagulant use on the success of mechanical thrombectomy in acute ischemic stroke cases. Methods: 174 patients who were brought to the Stroke Center of Gaziantep University Sahinbey Research and Practice Hospital between January 2018 and February 2019 due to acute ischemic stroke and who underwent mechanical thrombectomy were retrospectively analyzed. The demographic characteristics, antiplatelet/anticoagulant use before the stroke and mTICI (modified-Throm-bolysis-In-Cerebral-Infarction) scores used for reperfusion in mechanical thrombectomy were evaluated. The findings were analyzed statistically (p<0.05). Results: The mean age was 63.3 ± 13.5 in 174 patients who underwent mechanical thrombectomy. 23/174 (13.2%) patients were using anticoagulant therapy (warfarin-OAC or new generation oral anticoagulant-NOAC) and 28/174 (16.1%) were using antiplatelet therapy. A history of atrial fibrillation (AF) was significantly higher in patients receiving anticoagulant therapy before acute ischemic stroke (p=0.001). Patients with a history of hyper tension (HT), diabetes mellitus (DM) and coronary artery disease (CAD) before acute ischemic stroke were receiving antiplatelet therapy in higher rates (respectively; p=0.003, p=0.037, p=0.005). Successful recanalization (mTICI ≥ 2b) was higher in patients with a history of anticoagulant use and who underwent mechanical thrombectomy (p=0.025). Conclusion: Our study showed that the use of anti-platelet or anticoagulants before mechanical thrombec-tomy may have an indirect positive effect on the success of the procedure.