Outcomes of mechanical thrombectomy in orally anticoagulated patients with anterior circulation large vessel occlusion: a propensity-matched analysis of the Imperial College Thrombectomy Registry

• DOI: 10.1007/s00415-023-11926-5
• Publication Date: 2023-08-18T18:02:12Z
• Authors: Lucio D’Anna; Michele Romoli; Matteo Foschi; Samir Abu-Rumeileh; Tsering Dolkar; Orsolya Vittay; Luke Dixon; Paul Bentley; Zoe Brown; Charles Hall; Sohaa Jamil; Harri Jenkins; Joseph Kwan; Roberta La Cava; Maneesh Patel; Neil Rane; Dylan Roi; Abhinav Singh; Marius Venter; Omid Halse; Abid Malik; Dheeraj Kalladka; Soma Banerjee; Kyriakos Lobotesis
• Keywords: Stroke; Neuroradiology

Abstract Background Mechanical thrombectomy (MT) remains an effective treatment for patients with acute ischemic stroke receiving oral anticoagulation (OAC) and large vessel occlusion (LVO). However, to date, it unclear whether MT is safe in on OAC. Aims In our study, we performed a propensity-matched analysis investigate the safety efficacy of anticoagulants. A propensity score method was used target causal inference observational study design. Methods This observational, prospective, single-centre included consecutive LVO anterior circulation. Demographic, neuro-imaging clinical data were collected compared according status at baseline, OAC vs those not The primary outcomes occurrence any intracerebral haemorrhage (ICH) symptomatic ICH. secondary functional independence 90 days after (defined as modified Rankin Scale (mRS) scores 0 through 2), mortality 3 months successful reperfusion rate cerebral infarction (mTICI) score. Results Overall, cohort 573 treated MT. After matching, 495 matched (99 group 396 no group). There differences terms characteristics between two groups, except intravenous thrombolysis less frequently given group. significant difference ICH groups. With regards outcome, there recanalization post-procedure Patients showed reduced previous use (20.2% 21.2%, p = 0.031). Logistic regression did reveal statistically influence likelihood (OR 0.95, 95% CI 0.46–1.97, 0.900) 4.87, 0.64–37.1, 0.127). Our also that pre-admission anticoagulant associated 0.76, 0.39–1.48, 0.422) 0.81, 0.38–1.72, 0.582). Conclusion According findings baseline raise suggestion concerns when provided standard guidelines. Confirmation these results larger controlled prospective cohorts necessary.