Safety of Mechanical Thrombectomy for Acute Ischemic Stroke in Patients with Thrombocytopenia

Title:Safety of Mechanical Thrombectomy for Acute Ischemic Stroke in Patients with Thrombocytopenia

Volume: 21

Author(s): Sujie Zheng, Fang Liu, Liang Yu, Xinzhao Jiang, Xiaoyan Wen, Xu Wang and Zongjie Shi*

Affiliation:

• Center for Rehabilitation Medicine, Department of Neurology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, 310014, China

Abstract:

Background and Aim: The impact of low platelet count on outcomes in patients with Acute Ischemic Stroke (AIS) undergoing Mechanical Thrombectomy (MT) is still unclear. In this study we have further explored the effect of thrombocytopenia on the safety and efficacy of MT in patients with anterior circulation Large Vessel Occlusion (LVO) stroke.

Materials and Methods: Patients with AIS who underwent MT at our center between June 2015 and November 2021 were examined. Based on the platelet count recorded on admission patients were divided into two groups: those with thrombocytopenia (<150 × 109/L) and those without thrombocytopenia (≥ 150 × 109/L). Symptomatic Intracranial Hemorrhage (sICH) was the primary safety outcome. The efficacy outcome was functional independence defined as a 90-day modified Rankin Scale (mRS) score of 0-2. Multivariate logistic regression models were used to determine the risk factors for post-procedure sICH and 90-day functional outcomes.

Results: Among 302 patients included in the study, thrombocytopenia was detected in 111 (36.8%) cases. Univariate analysis showed age, the proportion of atrial fibrillation, the rates of sICH, 90-day poor outcomes, and mortality to be higher in patients with thrombocytopenia (all p < 0.05). Multivariable analysis showed thrombocytopenia to be independently associated with a higher rate of sICH (OR 2.022, 95% CI 1.074-3.807, p =0.029) however, thrombocytopenia did not affect the 90-day functional outcomes (OR 1.045, 95%CI 0.490-2.230, p =0.909) and mortality (OR 1.389, 95% CI 0.467– 4.130 p = 0.554).

Conclusion: Thrombocytopenia may increase the risk of sICH but not affect the 90-day functional outcomes and mortality in patients with AIS treated with MT.

Cite this article as:

Zheng Sujie, Liu Fang, Yu Liang, Jiang Xinzhao, Wen Xiaoyan, Wang Xu and Shi Zongjie*, Safety of Mechanical Thrombectomy for Acute Ischemic Stroke in Patients with Thrombocytopenia, Current Neurovascular Research 2024; 21 () . https://dx.doi.org/10.2174/0115672026296867240626120014