Article Text
Abstract
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 1,282 acute ischemic stroke (AIS) patients who underwent MT in 37 centers across North America, Asia, and Europe from September 2017 to July 2021. Data on demographics, clinical presentation, treatment specifics, and outcomes were collected. The primary outcomes were functional outcomes at 90 days post-MT, measured by modified Rankin Scale (mRS) scores. Secondary outcomes included reperfusion rates, mortality, and hemorrhagic complications.
Results Of the patients, 312 (24%) were on anticoagulation therapy. Anticoagulated patients were older (median age 72 vs. 64 years; p<0.0001) and had a higher prevalence of atrial fibrillation (73% vs. 24%; p<0.0001). Their baseline National Institutes of Health Stroke Scale (NIHSS) scores were also higher (median 12 vs. 10; p=0.012). Before PSM, anticoagulated patients had lower rates of favorable 90-day outcomes (mRS 0–1: 32% vs. 39%, p=0.033; mRS 0–2: 46% vs. 56%, p=0.0051) and higher mortality (26% vs. 14%, p<0.0001). 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.
Disclosures B. Musmar: None. N. Adeeb: None. H. Salim: None. S. Ghozy: None. N. M Cancelliere: None. V. Mendes Pereira: None. P. Jabbour: None. A. A Dmytriw: None. A. Guenego: None.