RT Journal Article
SR Electronic
T1 Endovascular management of acute large vessel occlusion stroke in pregnancy is safe and feasible
JF Journal of NeuroInterventional Surgery
JO J NeuroIntervent Surg
FD BMJ Publishing Group Ltd.
SP 552
OP 556
DO 10.1136/neurintsurg-2019-015578
VO 12
IS 6
A1 Kaustubh Limaye
A1 Ann Van de Walle Jones
A1 Amir Shaban
A1 Shashvat Desai
A1 Sami Al Kasab
A1 Eyad Almallouhi
A1 Christine A Holmstedt
A1 Santiago Ortega-Gutierrez
A1 Diogo C Haussen
A1 Raul Nogueira
A1 Francisco Mont’Alverne
A1 Carlos Ragiotto
A1 Leticia C Rebello
A1 Tudor G Jovin
A1 David Hasan
A1 Ashutosh Jadhav
YR 2020
UL http://jnis.bmj.com/content/12/6/552.abstract
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.