1. Periprocedural heparin use in acute ischemic stroke endovascular therapy: the TREVO 2 trial
- Author
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Melanie Winningham, Bin Xiang, Tudor G Jovin, Helmi L. Lutsep, Wade S. Smith, Diogo C Haussen, Raul G Nogueira, Fadi Nahab, and David S Liebeskind
- Subjects
Male ,medicine.medical_specialty ,Tissue plasminogen activator ,Neurosurgical Procedures ,Perioperative Care ,Brain Ischemia ,03 medical and health sciences ,0302 clinical medicine ,Bolus (medicine) ,Postoperative Complications ,Internal medicine ,Post-hoc analysis ,medicine ,Humans ,Thrombolytic Therapy ,030212 general & internal medicine ,Prospective Studies ,Acute ischemic stroke ,Aged ,Aged, 80 and over ,business.industry ,Heparin ,Endovascular Procedures ,Anticoagulants ,General Medicine ,HEPARIN USE ,Middle Aged ,Surgery ,Clinical trial ,Stroke ,Treatment Outcome ,Cardiology ,Female ,Stents ,Neurology (clinical) ,business ,Complication ,030217 neurology & neurosurgery ,medicine.drug - Abstract
BackgroundThe use of periprocedural heparin has previously been reported to be safe and potentially beneficial during thrombectomy with older generation devices. We aimed to evaluate the safety and clinical outcomes of heparin use in the stent retriever era.MethodsA post hoc analysis of the TREVO 2 trial was performed comparing baseline characteristics and clinical outcomes between patients who received (HEP+) and those who did not receive periprocedural heparin (HEP−) while undergoing MERCI or TREVO clot retrieval.ResultsOf 173 patients, 58 (34%) received periprocedural heparin including 40 who received one preprocedural bolus (median 3000 units). Baseline characteristics among HEP+ and HEP− patients were similar except HEP+ patients had a lower NIH Stroke Scale (NIHSS) score (17 vs 19; p=0.04), lower IV tissue plasminogen activator use (38% vs 64%; pConclusionsThe use of periprocedural heparin in stent retriever thrombectomy is associated with a good clinical outcome at 90 days and similar rates of symptomatic intracranial hemorrhage. Further studies are warranted.Clinical trial registrationURL:http://www.clinicaltrials.gov. Unique identifier: NCT01270867; Post-results.
- Published
- 2017