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Background Peri-procedural blood loss and hemodilution occur in patients undergoing mechanical thrombectomy (MT) for ischemic stroke; however, its relationships with thrombectomy passes, procedure times, and clinical outcomes are unknown.Methods Consecutive patients undergoing MT for anterior circulation large-vessel occlusion ischemic strokes were identified at a Comprehensive Stroke Center. Clinical information, modified treatment in cerebral ischemia (mTICI) scores, and modified Rankin Scores (mRS) at 90 days were prospectively collected from 2012 to 2021. Hemoglobin measurements before and after MTs were collected retrospectively via chart review, and changes were quantified. Patients with new-onset severe anemia (defined as post-MT hemoglobin less than 10g/dL) were identified. Modified Rankin scale (mRS) at 90 days was used to measure clinical outcomes.Results Four-hundred and forty-five patients were identified. Hemoglobin decreased 1.27 ± 1.05 g/dL after MT on average. Greater number of thrombectomy passes and longer procedure times were associated with larger decreases in hemoglobin (p< 0.001 and p= 0.002, respectively). 11.5% (51 of 445) of patients had new-onset severe anemia, and this incidence was significantly higher with more thrombectomy passes (6.4% for one pass, 11.9% for two passes, and 17.4% for three or more passes; p= 0.010). In multivariable analyses, new-onset severe anemia was associated with significantly higher odds of 90-day poor outcomes (mRS 3-6, OR 2.70 [95%CI 1.12–6.51], p= 0.027) and death (OR 2.73 [95%CI 1.06–7.04], p= 0.037) compared to mild post-MT anemia.Conclusions More thrombectomy passes and longer procedure times were significantly associated with larger peri-procedural decreases in hemoglobin. Patients with new-onset hemoglobin less than 10 g/dL are at risk of poor outcomes.

Background:Cryoballoon ablation (CBA) is the recommended therapy for patients with paroxysmal atrial fibrillation (AF) refractory to anti-arrhythmic drug therapy. In spite of significant procedural advancements, only two thirds of patients benefit from CBA. Left atrial volume index (LAVI) is a surrogate marker of left atrial size which is a known risk factor for development of AF. The role of increased LAVI as a predictor of recurrence of atrial arrhythmias (AA) following CBA for paroxysmal AF is unclear.Methods:We followed 101 patients with paroxysmal AF undergoing CBA for one year post procedure for development of AA. Evidence of recurrence was assessed by documented AA on EKG or any form of long term cardiac rhythm monitoring. Presence of elevated LAVI as a predictor of recurrence was evaluated in a multivariate cox proportional hazard model.Results:A total of 101 patients (Age 60.6 ? 9.1, 29% women) undergoing CBA were followed for one year to assess development of AA. Study population was divided into two groups based on LAVI greater or less than 34 ml/m2. Baseline demographics were similar between the two groups. On a multivariate cox proportional hazard model adjusted for baseline demographics and risk factors for development of AF, presence of increased LAVI did not predict recurrence of AA following CBA (Table, p=0.5). Furthermore, on Kaplan-Meier analysis increased LAVI was not a significant predictor of time to first recurrence of AA (Figure, p=0.18).Conclusion:Increased left atrial size is a known risk factor for development of AF. However, in our study population increased LAVI showed no correlation in predicting recurrence of AA following CBA for paroxysmal AF.