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

Sujie      Zheng; Fang      Liu; Liang      Yu; Xinzhao      Jiang; Xiaoyan      Wen; Xu      Wang; Zongjie      Shi

doi:10.2174/0115672026296867240626120014

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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.

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DOI https://dx.doi.org/10.2174/0115672026296867240626120014	Print ISSN 1567-2026
Publisher Name Bentham Science Publisher	Online ISSN 1875-5739

Current Neurovascular Research

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

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