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Safety and efficacy of mechanical thrombectomy in acute ischemic stroke of anticoagulated patients

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Safety and efficacy of mechanical thrombectomy in acute ischemic stroke of anticoagulated patients. / L'Allinec, Vincent; Ernst, Marielle; Sevin-Allouet, Mathieu; Testard, Nathalie; Delasalle-Guyomarch, Béatrice; Guillon, Benoit; Mazighi, Mikael; Desal, Hubert; Bourcier, Romain; NTF investigators.

In: J NEUROINTERV SURG, Vol. 10, No. 12, 12.2018, p. e29.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

L'Allinec, V, Ernst, M, Sevin-Allouet, M, Testard, N, Delasalle-Guyomarch, B, Guillon, B, Mazighi, M, Desal, H, Bourcier, R & NTF investigators 2018, 'Safety and efficacy of mechanical thrombectomy in acute ischemic stroke of anticoagulated patients', J NEUROINTERV SURG, vol. 10, no. 12, pp. e29. https://doi.org/10.1136/neurintsurg-2017-013714

APA

L'Allinec, V., Ernst, M., Sevin-Allouet, M., Testard, N., Delasalle-Guyomarch, B., Guillon, B., Mazighi, M., Desal, H., Bourcier, R., & NTF investigators (2018). Safety and efficacy of mechanical thrombectomy in acute ischemic stroke of anticoagulated patients. J NEUROINTERV SURG, 10(12), e29. https://doi.org/10.1136/neurintsurg-2017-013714

Vancouver

L'Allinec V, Ernst M, Sevin-Allouet M, Testard N, Delasalle-Guyomarch B, Guillon B et al. Safety and efficacy of mechanical thrombectomy in acute ischemic stroke of anticoagulated patients. J NEUROINTERV SURG. 2018 Dec;10(12):e29. https://doi.org/10.1136/neurintsurg-2017-013714

Bibtex

@article{d2de6a59b95f49928927a01390178a98,
title = "Safety and efficacy of mechanical thrombectomy in acute ischemic stroke of anticoagulated patients",
abstract = "BACKGROUND: Anticoagulated patients (APs) are currently excluded from acute ischemic stroke reperfusion therapy with intravenous recombinant tissue plasminogen activator (IV-rtPA); however, these patients could benefit from mechanical thrombectomy (MT). Evidence for MT in this condition remains scarce. The aim of this study was to analyze the safety and efficacy of MT in APs.METHODS: We analyzed three patient groups from two prospective registries: APs with MT (AP-MT group), non-anticoagulated patients treated with MT (NAP-MT group), and non-anticoagulated patients treated with IV-rtPA and MT (NAP-IVTMT group). Univariate and multivariate logistic regression were used to evaluate treatment efficacy with modified Rankin Scale (mRS) ≤2 and safety (radiologic intracranial hemorrhage (rICH), symptomatic intracranial hemorrhage (sICH) and death rate at 3 months) between groups.RESULTS: 333 patients were included in the study, with 44 (12%) in the AP-MT group, 105 (31%) in the NAP-MT group, and 188 (57%) in the NAP-IVTMT group. Univariate analysis showed that the AP-MT group was older (P<0.001), more often had atrial fibrillation (P<0001), and had a higher ASPECTS (P<0.006 and P<0.002) compared with the NAP-MT group and NAP-IVTMT groups, respectively. Multivariate analysis showed that the AP-MT group had a lower risk of rICH (OR 2.77, 95% CI 1.01 to 7.61, P=0.05) but a higher risk of death at 3 months (OR 0.26, 95% CI 0.09 to 0.76, P=0.01) compared with the NAP-IVTMT group. No difference was found between the AP-MT and NAP-MT groups.CONCLUSIONS: With regard to intracranial bleeding and functional outcome at 3 months, MT in APs seems as safe and efficient as in NAPs. However, there is a higher risk of death at 3 months in the AP-MT group compared with the NAP-IVTMT group.",
keywords = "Journal Article",
author = "Vincent L'Allinec and Marielle Ernst and Mathieu Sevin-Allouet and Nathalie Testard and B{\'e}atrice Delasalle-Guyomarch and Benoit Guillon and Mikael Mazighi and Hubert Desal and Romain Bourcier and {NTF investigators}",
note = "{\textcopyright} Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.",
year = "2018",
month = dec,
doi = "10.1136/neurintsurg-2017-013714",
language = "English",
volume = "10",
pages = "e29",
journal = "J NEUROINTERV SURG",
issn = "1759-8478",
publisher = "BMJ PUBLISHING GROUP",
number = "12",

}

RIS

TY - JOUR

T1 - Safety and efficacy of mechanical thrombectomy in acute ischemic stroke of anticoagulated patients

AU - L'Allinec, Vincent

AU - Ernst, Marielle

AU - Sevin-Allouet, Mathieu

AU - Testard, Nathalie

AU - Delasalle-Guyomarch, Béatrice

AU - Guillon, Benoit

AU - Mazighi, Mikael

AU - Desal, Hubert

AU - Bourcier, Romain

AU - NTF investigators

N1 - © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

PY - 2018/12

Y1 - 2018/12

N2 - BACKGROUND: Anticoagulated patients (APs) are currently excluded from acute ischemic stroke reperfusion therapy with intravenous recombinant tissue plasminogen activator (IV-rtPA); however, these patients could benefit from mechanical thrombectomy (MT). Evidence for MT in this condition remains scarce. The aim of this study was to analyze the safety and efficacy of MT in APs.METHODS: We analyzed three patient groups from two prospective registries: APs with MT (AP-MT group), non-anticoagulated patients treated with MT (NAP-MT group), and non-anticoagulated patients treated with IV-rtPA and MT (NAP-IVTMT group). Univariate and multivariate logistic regression were used to evaluate treatment efficacy with modified Rankin Scale (mRS) ≤2 and safety (radiologic intracranial hemorrhage (rICH), symptomatic intracranial hemorrhage (sICH) and death rate at 3 months) between groups.RESULTS: 333 patients were included in the study, with 44 (12%) in the AP-MT group, 105 (31%) in the NAP-MT group, and 188 (57%) in the NAP-IVTMT group. Univariate analysis showed that the AP-MT group was older (P<0.001), more often had atrial fibrillation (P<0001), and had a higher ASPECTS (P<0.006 and P<0.002) compared with the NAP-MT group and NAP-IVTMT groups, respectively. Multivariate analysis showed that the AP-MT group had a lower risk of rICH (OR 2.77, 95% CI 1.01 to 7.61, P=0.05) but a higher risk of death at 3 months (OR 0.26, 95% CI 0.09 to 0.76, P=0.01) compared with the NAP-IVTMT group. No difference was found between the AP-MT and NAP-MT groups.CONCLUSIONS: With regard to intracranial bleeding and functional outcome at 3 months, MT in APs seems as safe and efficient as in NAPs. However, there is a higher risk of death at 3 months in the AP-MT group compared with the NAP-IVTMT group.

AB - BACKGROUND: Anticoagulated patients (APs) are currently excluded from acute ischemic stroke reperfusion therapy with intravenous recombinant tissue plasminogen activator (IV-rtPA); however, these patients could benefit from mechanical thrombectomy (MT). Evidence for MT in this condition remains scarce. The aim of this study was to analyze the safety and efficacy of MT in APs.METHODS: We analyzed three patient groups from two prospective registries: APs with MT (AP-MT group), non-anticoagulated patients treated with MT (NAP-MT group), and non-anticoagulated patients treated with IV-rtPA and MT (NAP-IVTMT group). Univariate and multivariate logistic regression were used to evaluate treatment efficacy with modified Rankin Scale (mRS) ≤2 and safety (radiologic intracranial hemorrhage (rICH), symptomatic intracranial hemorrhage (sICH) and death rate at 3 months) between groups.RESULTS: 333 patients were included in the study, with 44 (12%) in the AP-MT group, 105 (31%) in the NAP-MT group, and 188 (57%) in the NAP-IVTMT group. Univariate analysis showed that the AP-MT group was older (P<0.001), more often had atrial fibrillation (P<0001), and had a higher ASPECTS (P<0.006 and P<0.002) compared with the NAP-MT group and NAP-IVTMT groups, respectively. Multivariate analysis showed that the AP-MT group had a lower risk of rICH (OR 2.77, 95% CI 1.01 to 7.61, P=0.05) but a higher risk of death at 3 months (OR 0.26, 95% CI 0.09 to 0.76, P=0.01) compared with the NAP-IVTMT group. No difference was found between the AP-MT and NAP-MT groups.CONCLUSIONS: With regard to intracranial bleeding and functional outcome at 3 months, MT in APs seems as safe and efficient as in NAPs. However, there is a higher risk of death at 3 months in the AP-MT group compared with the NAP-IVTMT group.

KW - Journal Article

U2 - 10.1136/neurintsurg-2017-013714

DO - 10.1136/neurintsurg-2017-013714

M3 - SCORING: Journal article

C2 - 29602862

VL - 10

SP - e29

JO - J NEUROINTERV SURG

JF - J NEUROINTERV SURG

SN - 1759-8478

IS - 12

ER -