Safety of endovascular thrombectomy in patients receiving non-vitamin K antagonist oral anticoagulants
File(s)
Author(s)
Type
Journal Article
Abstract
Background and Purpose—Prospective data on the safety of endovascular thrombectomy in acute stroke patients on non–
vitamin K antagonist oral anticoagulants are lacking.
Methods—Prospective multicenter observational study. Patients with ischemic stroke undergoing thrombectomy with or
without preceding thrombolysis were enrolled into the Registry of Acute Ischemic Stroke Under New Oral Anticoagulants.
Baseline characteristics and functional outcome at 3 months were assessed. Hemorrhagic transformation and symptomatic
intracranial hemorrhage were analyzed. Reperfusion was graded using the modified Thrombolysis in Cerebral Infarction
score.
Results—Of 28 patients treated with thrombectomy, 5 had received also systemic thrombolysis (18%). Intracranial
hemorrhage was observed in 46%, but symptomatic intracranial hemorrhage occurred only in 1 patient. Successful
reperfusion (Thrombolysis in Cerebral Infarction score, 2b–3) was achieved in 59%. At 3 months, 19% had a modified
Rankin Scale score of 0 to 2, and mortality was 26%.
Conclusions—Thrombectomy in non–vitamin K antagonist oral anticoagulant patients seems safe although a comparatively
high rate of asymptomatic hemorrhagic transformation was noted. Confirmation in larger prospective controlled cohorts
is necessary
vitamin K antagonist oral anticoagulants are lacking.
Methods—Prospective multicenter observational study. Patients with ischemic stroke undergoing thrombectomy with or
without preceding thrombolysis were enrolled into the Registry of Acute Ischemic Stroke Under New Oral Anticoagulants.
Baseline characteristics and functional outcome at 3 months were assessed. Hemorrhagic transformation and symptomatic
intracranial hemorrhage were analyzed. Reperfusion was graded using the modified Thrombolysis in Cerebral Infarction
score.
Results—Of 28 patients treated with thrombectomy, 5 had received also systemic thrombolysis (18%). Intracranial
hemorrhage was observed in 46%, but symptomatic intracranial hemorrhage occurred only in 1 patient. Successful
reperfusion (Thrombolysis in Cerebral Infarction score, 2b–3) was achieved in 59%. At 3 months, 19% had a modified
Rankin Scale score of 0 to 2, and mortality was 26%.
Conclusions—Thrombectomy in non–vitamin K antagonist oral anticoagulant patients seems safe although a comparatively
high rate of asymptomatic hemorrhagic transformation was noted. Confirmation in larger prospective controlled cohorts
is necessary
Date Issued
2016-04-01
Date Acceptance
2016-01-29
Citation
Stroke, 2016, 47 (4), pp.1127-1130
ISSN
1524-4628
Publisher
American Heart Association
Start Page
1127
End Page
1130
Journal / Book Title
Stroke
Volume
47
Issue
4
Copyright Statement
© 2016 American Heart Association, Inc.
Subjects
Science & Technology
Life Sciences & Biomedicine
Clinical Neurology
Peripheral Vascular Disease
Neurosciences & Neurology
Cardiovascular System & Cardiology
anticoagulants
intracranial hemorrhage
stroke
thrombectomy
ACUTE ISCHEMIC-STROKE
Publication Status
Published