Tehran University of Medical Sciences

Science Communicator Platform

Stay connected! Follow us on X network (Twitter):
Share this content! On (X network) By
Outcomes of Mechanical Thrombectomy for Acute Ischemic Stroke Following Cardiac Interventions: A Systematic Review and Meta-Analysis Publisher Pubmed



Jazayeri SB1, 2 ; Aljanabi OM3 ; Ghozy S2, 4 ; Rabinstein AA5 ; Kadirvel R2 ; Kallmes DF2
Authors
Show Affiliations
Authors Affiliations
  1. 1. Sina Trauma and Surgery Research Center, Sina Hospital, Tehran University of Medical Sciences, 11365-3876, Building 7, Hassan-Abad Square, Tehran, Iran
  2. 2. Department of Radiology, Mayo Clinic, Rochester, MN, United States
  3. 3. Department of Neurology, Baptist Health, Lexington, KY, United States
  4. 4. Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, United States
  5. 5. Department of Neurology, Mayo Clinic, Rochester, United States

Source: CardioVascular and Interventional Radiology Published:2025


Abstract

Purpose: The purpose of this study is to pool the evidence on the safety and efficacy of mechanical thrombectomy (MT) in patients who develop acute ischemic stroke (AIS) due to large vessel occlusion (LVO) following recent cardiac interventions. Methods: PubMed, Embase and Scopus were searched from inception up to February 2024 using a combination of “cardiac interventions” and “mechanical thrombectomy” as keywords. Studies that evaluated AIS within 30 days of a recent cardiac intervention who underwent MT were included. The proportion of mortality, favorable functional outcome (modified Rankin Scale (mRS) 0–2), successful reperfusion (TICI ≥ 2b or TIMI ≥ 2) and symptomatic intracranial hemorrhage (sICH) were pooled using generalized linear mixed model. Results: Thirty-one case reports/series and 11 observational studies including 195 MT procedures were included. The patients’ mean age was 72 years. The most common cardiac intervention associated with AIS was transcatheter aortic valve replacement/implantation in 96/192 cases (50%). The median onset of stoke was 0 (IQR 0–3) days after cardiac intervention. Rate of successful reperfusion was 79.4% [95%confidence interval (CI) 66.7–88.1%], rate of mRS 0–2 after 90 days was 42.7% [95%CI 32.5–53.6%], and rate of mortality at 90 days was 30.3% [95%CI 21.7–40.6%]. The rate of sICH was 11.6% [95%CI 5.9–21.5%]. Conclusion: MT to treat AIS due to LVO after cardiac interventions may result in good rates of functional recovery, though mortality and sICH may be higher. Regular and repeated neurological examinations should be performed following cardiac interventions, with special attention to stroke. If stroke is detected, MT should be considered as a viable option. © Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2024.
Related Docs
1. Risk of Hemorrhagic Transformation After Mechanical Thrombectomy Without Versus With Iv Thrombolysis for Acute Ischemic Stroke: A Systematic Review and Meta-Analysis of Randomized Clinical Trials, American Journal of Neuroradiology (2024)
2. New Insights on the Predictive Value of Hypoperfusion Intensity Ratio in Thrombectomy: An Updated Systematic Review and Meta-Analysis With Multiple Cut-Offs, Journal of NeuroInterventional Surgery (2025)
3. Reevaluating the Role of Heparin During Mechanical Thrombectomy for Acute Ischemic Stroke: Increased Risks Without Functional Benefit, Clinical Neurology and Neurosurgery (2024)
4. Safety and Efficacy of Intravenous Thrombolytic Therapy in the Extended Window up to 24 Hours: A Systematic Review and Meta-Analysis, Annals of Clinical and Translational Neurology (2024)