IS INTRAVENOUS ASPIRIN SAFE FOR EMERGENT STENTING IN THROMBOLYSED PATIENTS TREATED BY MECHANICAL THROMBECTOMY?

Ingleton, A; Raseta, M; Roffe, C

Abstract

Introduction: Intraoperative stenting is used during mechanical thrombectomy (MT) to manage severe stenosis or dissection. Antiplatelet agents are required intraoperatively to maintain patency of the stent. However, antiplatelets are contraindicated in the first 24 hours after thrombolysis. We evaluated outcomes and complications of patients stented with and without intravenous aspirin during MT.

Methods: All patients who required emergent stenting during MT at our centre between 2010 and 2020 were included. Patients were thrombolysed before MT, unless there were contraindications. Aspirin 500 mg intravenously was given intraoperatively at the discretion of the operator. Outcomes (death, symptomatic intracranial haemorrhage (sICH), and functional outcome (modified Rankin scale: mRS) were ascertained at 90 days by an independent physician.

Results: 107 patients (mean age 65.0 SD 11.0 years, mean NIHSS 18 SD 13, 80 (75%) thrombolysed) had a stent placed. Of these 52 (48.6%) were given aspirin and 55 (51%) were not. There were no significant differences in outcome (mRS 0–2 50vs36%, sICH 6vs15%, death 21vs24%) with and without aspirin. Thrombolysed patients had overall better outcomes (mRS 0–2 48vs33% p ¼ 0.2, sICH 6vs22% p ¼ 0.03, death 16vs41% p ¼ 0.02) than patients not thrombolysed, with no difference between those also treated with aspirin or not.

Conclusions: Perioperative intravenous aspirin did not affect complications or functional outcome, whether given alone or in combination with thrombolysis. While the interpretation of the findings is limited by the small size of the cohort and the observational nature of the study, our data suggest that intraoperative aspirin for stenting during mechanical thrombectomy is safe.

Citation

Ingleton, A., Raseta, M., & Roffe, C. (2021). IS INTRAVENOUS ASPIRIN SAFE FOR EMERGENT STENTING IN THROMBOLYSED PATIENTS TREATED BY MECHANICAL THROMBECTOMY?. International Journal of Stroke, 16(3),

• Journal Article Type: Conference Paper
• Acceptance Date: Dec 17, 2021
• Online Publication Date: Dec 17, 2021
• Publication Date: Dec 17, 2021
• Deposit Date: Jun 23, 2023
• Journal: International Journal of Stroke
• Print ISSN: 1747-4930
• Publisher: SAGE Publications
• Peer Reviewed: Peer Reviewed
• Volume: 16
• Issue: 3