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Differential effect of mechanical thrombectomy and intravenous thrombolysis in atrial fibrillation associated stroke
- Source :
- Journal of Neurointerventional Surgery, Journal of Neurointerventional Surgery, BMJ Journals, 2020, pp.neurintsurg-2020-016720. ⟨10.1136/neurintsurg-2020-016720⟩, J Neurointerv Surg
- Publication Year :
- 2020
- Publisher :
- HAL CCSD, 2020.
-
Abstract
- BackgroundAtrial fibrillation (AF) associated ischemic stroke has worse functional outcomes, less effective recanalization, and increased rates of hemorrhagic complications after intravenous thrombolysis (IVT). Limited data exist about the effect of AF on procedural and clinical outcomes after mechanical thrombectomy (MT).ObjectiveTo determine whether recanalization efficacy, procedural speed, and clinical outcomes differ in AF associated stroke treated with MT.MethodsWe performed a retrospective cohort study of the Stroke Thrombectomy and Aneurysm Registry (STAR) from January 2015 to December 2018 and identified 4169 patients who underwent MT for an anterior circulation stroke, 1517 (36.4 %) of whom had comorbid AF. Prospectively defined baseline characteristics, procedural outcomes, and clinical outcomes were reported and compared.ResultsAF predicted faster procedural times, fewer passes, and higher rates of first pass success on multivariate analysis (pConclusionsIn patients treated with MT, comorbid AF is associated with faster procedural time, fewer passes, and increased rates of first pass success without increased risk of intracranial hemorrhage or worse functional outcomes. These results are in contrast to the increased hemorrhage rates and worse functional outcomes observed in AF associated stroke treated with supportive care and or IVT. These data suggest that MT negates the AF penalty in ischemic stroke.
- Subjects :
- medicine.medical_specialty
Multivariate analysis
medicine.medical_treatment
[SDV.IB.MN]Life Sciences [q-bio]/Bioengineering/Nuclear medicine
030204 cardiovascular system & hematology
Article
03 medical and health sciences
0302 clinical medicine
Aneurysm
Internal medicine
Atrial Fibrillation
medicine
[INFO.INFO-IM]Computer Science [cs]/Medical Imaging
Humans
In patient
Thrombolytic Therapy
Stroke
Retrospective Studies
Thrombectomy
business.industry
Atrial fibrillation
Retrospective cohort study
General Medicine
Thrombolysis
medicine.disease
Mechanical thrombectomy
Treatment Outcome
Cardiology
Surgery
Neurology (clinical)
business
030217 neurology & neurosurgery
[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Subjects
Details
- Language :
- English
- ISSN :
- 17598478 and 17598486
- Database :
- OpenAIRE
- Journal :
- Journal of Neurointerventional Surgery, Journal of Neurointerventional Surgery, BMJ Journals, 2020, pp.neurintsurg-2020-016720. ⟨10.1136/neurintsurg-2020-016720⟩, J Neurointerv Surg
- Accession number :
- edsair.doi.dedup.....25aaed55e96e0110aed710d661aef3d2