PT  - JOURNAL ARTICLE
AU  - Limaye, Kaustubh
AU  - Van de Walle Jones, Ann
AU  - Shaban, Amir
AU  - Desai, Shashvat
AU  - Al Kasab, Sami
AU  - Almallouhi, Eyad
AU  - Holmstedt, Christine A
AU  - Ortega-Gutierrez, Santiago
AU  - Haussen, Diogo C
AU  - Nogueira, Raul
AU  - Mont’Alverne, Francisco
AU  - Ragiotto, Carlos
AU  - Rebello, Leticia C
AU  - Jovin, Tudor G
AU  - Hasan, David
AU  - Jadhav, Ashutosh
TI  - Endovascular management of acute large vessel occlusion stroke in pregnancy is safe and feasible
AID  - 10.1136/neurintsurg-2019-015578
DP  - 2020 Jun 01
TA  - Journal of NeuroInterventional Surgery
PG  - 552--556
VI  - 12
IP  - 6
4099  - http://jnis.bmj.com/content/12/6/552.short
4100  - http://jnis.bmj.com/content/12/6/552.full
SO  - J NeuroIntervent Surg2020 Jun 01; 12
AB  - Introduction Stroke is a leading cause of adult death and disability. Although acute ischemic stroke (AIS) in pregnancy is rare, it has devastating consequences on the life of the mother and fetus. Pregnancy was an exclusion criterion in endovascular thrombectomy (EVT) trials and so there are no evidence-based treatment recommendations in this subgroup. The objective of this study was to evaluate the safety and feasibility of mechanical thrombectomy in large vessel occlusion (LVO) stroke in pregnancy.Methods Patients with AIS due to LVO treated with EVT during pregnancy between 2000 and 2019 were identified at seven tertiary care centers. After IRB approval, retrospective analysis of prospectively maintained stroke/endovascular databases was performed.Results A total of seven subjects were identified. The average age was 33.2 years (range 25–38 years) and the average initial National Institutes of Health Stroke Scale (NIHSS) score at presentation was 15 (range 9–28). Three patients received IV tissue plasminogen activator. Techniques of EVT included stent retriever thrombectomy, stent retriever-assisted continuous aspiration, direct contact aspiration, and multimodal techniques including a rescue balloon mounted coronary stent placement. While one patient was noted to have petechial hemorrhage, no individuals developed parenchymal hematoma. Mean discharge NIHSS score was 1.7 (range 0–5).Conclusion EVT is a safe and effective treatment for acute stroke secondary to LVO in this series of pregnant patients. While EVT for acute stroke is standard of care in select patient populations, our study suggests that treatment should be considered in the gravid population.