Mechanical Thrombectomy in Patients with Acute Ischemic Stroke on Anticoagulation Therapy.
Cardiovasc Intervent Radiol
; 41(5): 706-711, 2018 May.
Article
en En
| MEDLINE
| ID: mdl-29450625
ABSTRACT
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 ANDMETHODS:
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.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Isquemia Encefálica
/
Trombectomía
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Accidente Cerebrovascular
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Anticoagulantes
Tipo de estudio:
Observational_studies
Límite:
Aged
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Female
/
Humans
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Male
Idioma:
En
Revista:
Cardiovasc Intervent Radiol
Año:
2018
Tipo del documento:
Article
País de afiliación:
República Checa