Benefits and Safety of Periprocedural Heparin During Thrombectomy in Patients Contra-Indicated for Alteplase.
J Stroke Cerebrovasc Dis
; 29(10): 105052, 2020 Oct.
Article
em En
| MEDLINE
| ID: mdl-32912529
ABSTRACT
BACKROUND AND PURPOSE:
Role of peri-procedural heparin as an adjuvant treatment during mechanical thrombectomy (MT) for patients contra-indicated for alteplase remains a source of debate.METHODS:
We included patients from the multicenter French register ETIS that underwent MT without administration of alteplase, and compared patients who received heparin during MT with patients who did not. Heparin impact on outcome were analyzed regarding final TICI score, NIHSS at day one, modified rankin scale (mRS) and intracranial hemorrhagic transformation on imaging at day one.RESULTS:
Over 1031 patients, 751 were included between January 2015 and June 2018 in 6 different centers, and 223 (26.69%) received heparin. Heparin administration was associated with a significant deleterious effect on NIHSS at 24h [adjusted ORâ¯=â¯1.2; pâ¯=â¯0.02], mRS at 3 months [adjusted OR 1.58; pâ¯=â¯0.03], and on complete reperfusion [TICI 3 adjusted OR 0.68; pâ¯=â¯0.02]. Heparin administration was associated with a significant reduction of hemorrhagic transformation [adjusted OR 0.48; pâ¯=â¯0.00005].CONCLUSIONS:
Heparin administration during MT seems deleterious for reperfusion and functional outcome. Randomized trials are needed to identify the role of antithrombotic treatments, such as heparin, in the setting of acute ischemic stroke management.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Heparina
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Terapia Trombolítica
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Isquemia Encefálica
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Ativador de Plasminogênio Tecidual
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Trombectomia
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Acidente Vascular Cerebral
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Fibrinolíticos
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Contraindicações de Medicamentos
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Anticoagulantes
Tipo de estudo:
Diagnostic_studies
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Etiology_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
País como assunto:
Europa
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article