Recanalization Therapies in Acute Ischemic Stroke Patients

• DOI: 10.1161/circulationaha.115.015484
• Publication Date: 2015-08-01T02:40:09Z
• Authors: David J. Seiffge; Robbert-JanVan Hooff; Christian H. Nolte; Yannick Béjot; Guillaume Turc; Benno Ikenberg; Eivind Berge; Malte Persike; Nelly Dequatre-Po...; Daniel Strbian; Waltraud Pfeilsch...; Andrea Zini; Arnstein Tveiten; Halvor Næss; Patrik Michel; Roman Sztajzel; Andreas Luft; Henrik Gensicke; Christopher Traenka; Lisa Hert; Jan F. Scheitz; Gian Marco De Mar...; Leo H. Bonati; Nils Peters; Andreas Charidimou; David J. Werring; Frederick Palm; Matthias Reinhard; Wolf-Dirk Niesen; Takehiko Nagao; Alessandro Pezzini; Valeria Caso; Paul J. Nederkoorn; Georg Kägi; Alexander von Hes...; Visnja Padjen; Charlotte Cordonnier; Hebun Erdur; Philippe A. Lyrer; Raf Brouns; Thorsten Steiner; Turgut Tatlisumak; Stefan T. Engelter
• Keywords: Interquartile range; Stroke; Vitamin K antagonist

We explored the safety of intravenous thrombolysis (IVT) or intra-arterial treatment (IAT) in patients with ischemic stroke on non-vitamin K antagonist oral anticoagulants (NOACs, last intake <48 hours) comparison (1) taking vitamin antagonists (VKAs) (2) without previous anticoagulation (no-OAC).This is a multicenter cohort pilot study. Primary outcome measures were occurrence intracranial hemorrhage (ICH) 3 categories: any ICH (ICHany), symptomatic according to criteria European Cooperative Acute Stroke Study II (ECASS-II) (sICHECASS-II) and National Institute Neurological Disorders (NINDS) trial (sICHNINDS); death (at months). Cohorts compared by using propensity score matching. Our NOAC comprised 78 treated IVT/IAT groups 441 VKA 8938 no-OAC patients. The median time from was 13 hours (interquartile range, 8-22 hours). In patients, pre-IVT/IAT international normalized ratio 1.3 1.1-1.6). ICHany observed 18.4% versus 26.8% 17.4% sICHECASS-II sICHNINDS occurred 2.6%/3.9% 6.5%/9.3% 5.0%/7.2% respectively. At months, 23.0% 26.9% 13.9% had died. Propensity matching revealed no statistically significant differences.IVT/IAT selected under has profile similar both subtherapeutic those anticoagulation. However, further prospective studies are needed, including impact specific coagulation tests.