PT - JOURNAL ARTICLE AU - Bay, Benjamin AU - Gloyer, Nils-Ole AU - Remmel, Marko AU - Schell, Maximilian AU - Zelenak, Kamil AU - Seiffert, Moritz AU - Brunner, Fabian J AU - Clemmensen, Peter AU - Reichenspurner, Hermann AU - Blankenberg, Stefan AU - Thomalla, Goetz AU - Fiehler, Jens AU - Conradi, Lenard AU - Waldeyer, Christoph AU - Flottmann, Fabian TI - Mechanical thrombectomy in ischemic stroke after cardiovascular procedures: a propensity-matched cohort analysis AID - 10.1136/jnis-2022-019152 DP - 2023 Sep 01 TA - Journal of NeuroInterventional Surgery PG - e129--e135 VI - 15 IP - e1 4099 - http://jnis.bmj.com/content/15/e1/e129.short 4100 - http://jnis.bmj.com/content/15/e1/e129.full SO - J NeuroIntervent Surg2023 Sep 01; 15 AB - Background Stroke after a cardiovascular procedure (CVP) is a devastating complication adversely affecting outcome. Mechanical thrombectomy (MT) has not been investigated systematically in this population.Objective To carry out a retrospective study in patients undergoing MT for early stroke after CVP, aiming to further characterize this cohort of patients, and to evaluate the efficacy, safety, procedural characteristics, and outcome of MT.Methods A single-center stroke registry of patients who received MT was analyzed. Baseline and procedural parameters, mortality, functional outcome, recanalization rates, and complications were evaluated. Propensity score matching was carried out, identifying a control cohort with non-periprocedural large vessel occlusion (LVO).Results Overall 913 patients were included (mean age 73.0 (±13.0) years, 52.5% female, median National Institutes of Health Stroke Scale score 15 (10–19)). Eleven patients with a LVO after a recent (<30 days postoperatively) CVP were identified (n=3 transcatheter aortic valve and n=1 surgical aortic valve replacements (SAVR), n=3 coronary bypass grafting (CABG) surgeries, n=2 SAVR+CABG, and n=2 aortic surgeries). After matching, 8 patients in the CVP group were compared with 16 patients in the matched cohort. Comparable rates of reperfusion were achieved. Time from symptom onset to groin puncture (171.5 min (136.3, 178.3) vs 284.0 min (215.0, 490.5); p=0.039), as well as recanalization (195.0 min (146.0, 201.0) vs 419.0 min (274.0, 613.0); p=0.028) was faster in the CVP group. However, this was not reflected by an improved outcome (modified Rankin Scale score after 90 days: 5.5 (3.3, 6.0) vs 5.0 (4.0, 6.0), mortality after 90 days 50.0% vs 37.5%). Complications did not differ between the groups.Conclusions Use of MT for LVO stroke in patients after a recent CVP is a safe and efficient treatment in comparison with patients with a non-periprocedural LVO undergoing MT.Data are available upon reasonable request. The data that support the findings of this study are available from the corresponding author upon reasonable request.