Tehran University of Medical Sciences

Science Communicator Platform

Stay connected! Follow us on X network (Twitter):
Share this content! On (X network) By
Efficacy and Safety of Mechanical Thrombectomy in Patients With Acute Ischemic Stroke and Left Ventricular Assist Device: Review of the Literature and Meta-Analysis Publisher Pubmed



Jazayeri SB1 ; Aljanabi OM2 ; Alateya A3 ; Muhammad S4 ; Ghozy S5, 6 ; Rabinstein AA7 ; Kadirvel R5, 6 ; Kallmes DF5
Authors
Show Affiliations
Authors Affiliations
  1. 1. Tehran University of Medical Sciences, Sina Trauma and Surgery Research Center, Tehran, Iran
  2. 2. Department of Neurology, Baptist Health Lexington, Lexington, KY, United States
  3. 3. Royal College of Surgeons in Ireland, Busaiteen, Bahrain
  4. 4. Department of Neurology, New York Medical College, Valhalla, NY, United States
  5. 5. Department of Radiology, Mayo Clinic, Rochester, MN, United States
  6. 6. Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, United States
  7. 7. Department of Neurology, Mayo Clinic, Rochester, MN, United States

Source: Journal of NeuroInterventional Surgery Published:2025


Abstract

Background: Left ventricular assist devices (LVADs) are used as definitive therapy or as a bridge to heart transplant in patients with advanced heart failure. Thromboembolic complications such as acute ischemic stroke (AIS) are common among patients with LVAD support. This study aims to evaluate the current evidence on the efficacy and safety of mechanical thrombectomy (MT) in patients with AIS due to large vessel occlusions (LVO) and LVAD-support. Methods: A comprehensive systematic review was conducted in PubMed, Embase, and Scopus to find observational studies with reports of ≥5 MTs in adult patients with LVAD support (PROSPERO registration code CRD42024597541). Rates of successful and complete reperfusion, favorable functional outcomes at 90 days (modified Rankin Scale (mRS) 0-2 or equal to pre-stroke mRS), mortality at 90 days, any intracerebral hemorrhage (ICH) and symptomatic ICH (sICH) were pooled using generalized linear mixed models. Results: Eight studies were included with data from 51 patients and 62 MTs. The rate of successful reperfusion was 87.4% (95% CI 62.5% to 96.6%) and complete reperfusion rate was 57.3% (95% CI 35.1% to 76.9%). Rate of favorable functional recovery was 62.5% (95% CI 42.2% to 79.2%). Rate of sICH was 6.4% (95% CI 0.9% to 34.0%). Mortality rate was 16.7% (95% CI 7.1% to 34.7%). Between 25-40% of patients who were waiting for a heart transplant before their stroke received a heart transplant after MT. Conclusions: MT for the emergent treatment of AIS in the setting of LVAD is relatively safe and efficacious for achieving successful reperfusion and good functional recovery. © Author(s) (or their employer(s)) 2025.
Related Docs
1. Direct Mechanical Thrombectomy Versus Prior Bridging Intravenous Thrombolysis in Acute Ischemic Stroke: A Systematic Review and Meta-Analysis, Life (2023)
2. The Safety and Efficacy of Neva Mechanical Thrombectomy Device in Acute Ischemic Stroke: A Systematic Review and Meta-Analysis, Journal of Clinical Neuroscience (2024)
3. Anterior Ischemic Stroke: Analysis of the Multivariable Ct-Based Models for Prediction of Clinical Outcome, Journal of Stroke and Cerebrovascular Diseases (2023)
4. Therapeutic Potential of Stem Cells for Treatment of Neurodegenerative Diseases, Biotechnology Letters (2020)
5. 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)