Outcomes of mechanical thrombectomy in anticoagulated patients with acute distal and medium vessel stroke

Hamza Salim; Basel Musmar; Nimer Adeeb; Vivek Yedavalli; Dhairya Lakhani; Sahibjot Singh Grewal; Kareem El Naamani; Nils Henninger; Sri Hari Sundararajan; Anna Luisa Kuehn; Jane Khalife; Sherief Ghozy; Luca Scarcia; Benjamin Y. Q. Tan; Robert W. Regenhardt; Jeremy J. Heit; Nicole M. Cancelliere; Joshua D. Bernstock; Aymeric Rouchaud; Jens Fiehler; Sunil Sheth; Ajit S. Puri; Christian Dyzmann; Marco Colasurdo; Xavier Barreau; Leonardo Renieri; Joo Pedro Filipe; Pablo Harker; Razvan Alexandru Radu; Mohamad Abdalkader; Piers Klein; Thomas R. Marotta; Julian Spears; Takahiro Ota; Ashkan Mowla; Pascal Jabbour; Arundhati Biswas; Frederic Clarencon; James E. Siegler; Thanh N. Nguyen; Ricardo Varela; Amanda Baker; Muhammed Amir Essibayi; David Altschul; Nestor R. Gonzalez; Markus A. Moehlenbruch; Vincent Costalat; Benjamin Gory; Christian Paul Stracke; Mohammad Ali Aziz-Sultan; Constantin Hecker; Hamza Shaikh; David S. Liebeskind; Alessandro Pedicelli; Andrea M. Alexandre; Illario Tancredi; Tobias D. Faizy; Erwah Kalsoum; Boris Lubicz; Aman B. Patel; Vitor Mendes Pereira; Adrien Guenego; Adam A. Dmytriw; Mad MT Investigators

doi:10.1177/23969873241249295

Retour

Outcomes of mechanical thrombectomy in anticoagulated patients with acute distal and medium vessel stroke

Article de revue

Avec comité de lecture

Outcomes of mechanical thrombectomy in anticoagulated patients with acute distal and medium vessel stroke

Hamza Salim, Basel Musmar, Nimer Adeeb, Vivek Yedavalli, Dhairya Lakhani, Sahibjot Singh Grewal, Kareem El Naamani, Nils Henninger, Sri Hari Sundararajan, Anna Luisa Kuehn, …

European stroke journal, Vol.9(4), pp.896-906

01/12/2024

DOI: https://doi.org/10.1177/23969873241249295

PMID: 38726983

Résumé

Cardiovascular System & Cardiology

Clinical Neurology

Life Sciences & Biomedicine

Neurosciences & Neurology

Peripheral Vascular Disease

Science & Technology

Background: Stroke remains a major health concern globally, with oral anticoagulants widely prescribed for stroke prevention. The efficacy and safety of mechanical thrombectomy (MT) in anticoagulated patients with distal medium vessel occlusions (DMVO) are not well understood. Methods: This retrospective analysis involved 1282 acute ischemic stroke (AIS) patients who underwent MT in 37 centers across North America, Asia, and Europe from September 2017 to July 2023. Data on demographics, clinical presentation, treatment specifics, and outcomes were collected. The primary outcomes were functional outcomes at 90days post-MT, measured by modified Rankin Scale (mRS) scores. Secondary outcomes included reperfusion rates, mortality, and hemorrhagic complications. Results: Of the patients, 223 (34%) were on anticoagulation therapy. Anticoagulated patients were older (median age 78 vs 74years; p<0.001) and had a higher prevalence of atrial fibrillation (77% vs 26%; p<0.001). Their baseline National Institutes of Health Stroke Scale (NIHSS) scores were also higher (median 12 vs 9; p=0.002). Before propensity score matching (PSM), anticoagulated patients had similar rates of favorable 90-day outcomes (mRS 0-1: 30% vs 37%, p=0.1; mRS 0-2: 47% vs 50%, p=0.41) but higher mortality (26% vs 17%, p=0.008). After PSM, there were no significant differences in outcomes between the two groups. Conclusion: Anticoagulated patients undergoing MT for AIS due to DMVO did not show significant differences in 90-day mRS outcomes, reperfusion, or hemorrhage compared to non-anticoagulated patients after adjustment for covariates.

Indicateurs

1 Consultations de la notice

Détails

Titre: Outcomes of mechanical thrombectomy in anticoagulated patients with acute distal and medium vessel stroke
Créateurs - sans rôle: Hamza Salim - College Station Medical Center
Basel Musmar - Thomas Jefferson University
Nimer Adeeb - Louisiana State University
Vivek Yedavalli - College Station Medical Center
Dhairya Lakhani - Johns Hopkins Med Ctr, Div Neuroradiol, Dept Radiol, Baltimore, MD USA
Sahibjot Singh Grewal - Univ Toronto, St Michael Hosp, Div Therapeut Neuroradiol & Neurosurg, Neurovasc Ctr, Toronto, ON, Canada
Kareem El Naamani - Thomas Jefferson University
Nils Henninger - Univ Massachusetts Chan Med Sch, Dept Neurol, Worcester, MA USA
Sri Hari Sundararajan - NJMS, Dept Endovasc Neurosurg & Neuroradiol, Newark, NJ USA
Anna Luisa Kuehn - Univ Massachusetts Med Ctr, Div Neurointervent Radiol, Dept Radiol, Worcester, MA USA
Jane Khalife - Rowen Univ, Cooper Univ Hosp, Cooper Neurol Inst, Cooper Med Sch, Camden, NJ USA
Sherief Ghozy - Mayo Clin, Dept Neurol Surg, Rochester, MN USA
Luca Scarcia - Henri Mondor Hosp, Dept Neuroradiol, Creteil, France
Benjamin Y. Q. Tan - Natl Univ Singapore, Yong Loo Lin Sch Med, Dept Med, Singapore, Singapore
Robert W. Regenhardt - Harvard Med Sch, Massachusetts Gen Hosp, Neuroendovasc Program, Boston, MA USA
Jeremy J. Heit - College Station Medical Center
Nicole M. Cancelliere - University of Toronto
Joshua D. Bernstock - Harvard Med Sch, Brigham & Womens Hosp, Dept Neurosurg, Boston, MA USA
Aymeric Rouchaud - Univ Limoges, Univ Hosp Limoges, Dept Neuroradiol, Dupuytren, Limoges, France
Jens Fiehler - Univ Med Ctr Hamburg Eppendorf, Dept Diagnost & Intervent Neuroradiol, Hamburg, Germany
Sunil Sheth - UTHealth McGovern Med Sch, Dept Neurol, Houston, TX USA
Ajit S. Puri - College Station Medical Center
Christian Dyzmann - Lubeck GmbH, Sana Klin, Dept Neuroradiol, Lubeck, Germany
Marco Colasurdo - University of Portland
Xavier Barreau - Bordeaux Univ Hosp, Intervent Neuroradiol Dept, Bordeaux, France
Leonardo Renieri - Osped Careggi Firenze, Interventist Neurovascol, Florence, Italy
Joo Pedro Filipe - Ctr Hosp Univ Porto, Dept Diagnost & Intervent Neuroradiol, Porto, Portugal
Pablo Harker - University of Cincinnati
Razvan Alexandru Radu - Montpellier Univ Med Ctr, Gui de Chauliac Hosp, Dept Neuroradiol, Montpellier, France
Mohamad Abdalkader - College Station Medical Center
Piers Klein - College Station Medical Center
Thomas R. Marotta - University of Toronto
Julian Spears - Univ Toronto, St Michael Hosp, Div Therapeut Neuroradiol & Neurosurg, Neurovasc Ctr, Toronto, ON, Canada
Takahiro Ota - Tokyo Metropolitan Tama Med Ctr, Dept Neurosurg, Tokyo, Japan
Ashkan Mowla - Univ Southern Calif USC, Keck Sch Med, Dept Neurol Surg, Div Stroke & Endovasc Neurosurg, Los Angeles, CA USA
Pascal Jabbour - Thomas Jefferson University
Arundhati Biswas - New York Medical College
Frederic Clarencon - Sorbonne Univ Paris VI, Pitie Salpetriere Hosp, Dept Neuroradiol, GRC BioFast, Paris, France
James E. Siegler - Rowen Univ, Cooper Univ Hosp, Cooper Neurol Inst, Cooper Med Sch, Camden, NJ USA
Thanh N. Nguyen - Boston Med Ctr, Dept Radiol, Boston, MA USA
Ricardo Varela - Ctr Hosp Univ Porto, Dept Neurol, Porto, Portugal
Amanda Baker - Albert Einstein College of Medicine
Muhammed Amir Essibayi - Albert Einstein College of Medicine
David Altschul - Albert Einstein College of Medicine
Nestor R. Gonzalez - College Station Medical Center
Markus A. Moehlenbruch - Univ Klinikum Heidelberg, Sekt Vaskulare & Intervent Neuroradiol, Heidelberg, Germany
Vincent Costalat - Montpellier Univ Med Ctr, Gui de Chauliac Hosp, Dept Neuroradiol, Montpellier, France
Benjamin Gory - Nancy Univ Hosp, Dept Intervent Neuroradiol, Nancy, France
Christian Paul Stracke - Univ Med Ctr Munster, Intervent Neuroradiol Sect, Dept Radiol, Munster, Germany
Mohammad Ali Aziz-Sultan - Harvard Med Sch, Brigham & Womens Hosp, Dept Neurosurg, Boston, MA USA
Constantin Hecker - University of Salzburg
Hamza Shaikh - Rowen Univ, Cooper Univ Hosp, Cooper Neurol Inst, Cooper Med Sch, Camden, NJ USA
David S. Liebeskind - UCLA, UCLA Stroke Ctr, Los Angeles, CA USA
Alessandro Pedicelli - Fdn Policlin Univ A Gemelli IRCCS Roma, UOSA Neuroradiol Interventist, Rome, Italy
Andrea M. Alexandre - Fdn Policlin Univ A Gemelli IRCCS Roma, UOSA Neuroradiol Interventist, Rome, Italy
Illario Tancredi - Hop Civil Marie Curie, Dept Neurol, Charleroi, Belgium
Tobias D. Faizy - Univ Med Ctr Munster, Neuroendovasc Program, Dept Radiol, Munster, Germany
Erwah Kalsoum - Henri Mondor Hosp, Dept Neuroradiol, Creteil, France
Boris Lubicz - Erasme Univ Hosp, Dept Diagnost & Intervent Neuroradiol, Brussels, Belgium
Aman B. Patel - Harvard Med Sch, Massachusetts Gen Hosp, Neuroendovasc Program, Boston, MA USA
Vitor Mendes Pereira - University of Toronto
Adrien Guenego - Erasme Univ Hosp, Dept Diagnost & Intervent Neuroradiol, Brussels, Belgium
Adam A. Dmytriw - Harvard Med Sch, Massachusetts Gen Hosp, Neuroendovasc Program, Boston, MA USA
Mad MT Investigators
Détails de publication: European stroke journal, Vol.9(4), pp.896-906
Éditeur: Sage
Nombre de pages: 11
Note de subvention: NS131756; U24NS113844 / ClinSearch (core lab) Johnson & Johnson and Phenox NR020231 / NINDS; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Neurological Disorders & Stroke (NINDS) Penumbra Arsenal Medical Medtronic CereVasc Heitman Stroke Foundation Balt NIH, Microvention; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; Office of the Administrator (NIH)
Identifiants: 99163020209311
Unité académique: Institut de Génomique Fonctionnelle - IGF
Langue: English
Type de ressource: Journal article