Symptomatic intracranial hemorrhage (sICH) involves a potential complication in patients treated with rtpa or mechanical thrombectomy (MT), which influences functional and vital prognosis of ischemic stroke patients. Patients under oral anticoagulation (OAC) suffer higher risk of sICH per se; however, the association of mentioned oral treatment with recanalization therapies (IV fibrinolysis or MT) may increase cerebral bleeding. This is the aim of Dr. Meinel and colleagues, among others, like mortality and sICH risk in MT patients under OAC, sensitivity analysis with patients with confirmed therapeutic anticoagulation activity, and finally the presentation of a meta-analysis about the topic.
The authors performed a retrospective, multicenter non-randomized observational study to investigate safety and efficacy of a market-release neurothrombectomy device, including their data in the BEYOND-SWIFT registry. Patients were grouped according to their OAC intake prior to admission: Group 1: VKA (vitamin K antagonist); Group 2: DOACs (Direct oral anticoagulants); Group 3: No OAC. The primary endpoint was sICH rate (according to ECASS II (European Co-Operative Acute Stroke Study-II) criteria). The secondary endpoints were technical efficacy and all-cause mortality at 3 months.