Abstract No. 443 Mechanical thrombectomy in patients with acute ischemic stroke on anticoagulation therapy

Abstract

Mechanical thrombectomy (MT) can be performed also in acute ischemic stroke (IS) patients using anticoagulation therapy (AT), however reported data has not been still enough consistent. Our aim was assess the safety and efficacy of MT in patients on AT. All consecutive IS patients treated with MT in both centers were enrolled in the retrospective analysis. In all patients, MT was performed using stent-retrievers, neurological deficit was scored using National Institutes of Health Stroke Scale (NIHSS) and 90day clinical outcome using modified Rankin scale (mRS) with score 0-2 for good outcome. Achieved recanalization was rated using Thrombolysis in Cerebral Infarction (TICI) scale. Symptomatic intracerebral haemorrhage (SICH) was assessed according to the SITS-MOST criteria. Out of 750 patients treated with MT, 76 patients (46% of males, mean age 73 years) were on AT with a median of admission NIHSS 16 points. 84% of patients had atrial fibrillation (AF). Overall recanalization was achieved in 90% and complete (TICI 3) in 78% of patients. ICH after MT was detected in 37% of patients and SICH in 11% of patients. 36% of patients had good outcome after 3 months. 7-day mortality was 8% and 37% of patients died within 3 months. MT seems to be safe also in patients on AT. Poor outcome with high 3-month mortality might be associated with presence of AF. Acknowledgment: Supported by grant: IGA LF UP_010_2017, RVO FNOL_00098892_2016 and IGA-KZ-2016-1-2.