Domas Bajerūnas1, Kotryna Mockaitytė1, Andrius Pranculis2, Algidas Basevičius3
1 Lithuanian University of Health Sciences, faculty of Medicine, Kaunas, Lithuania
2 Hospital of Lithuanian University of Health Sciences, department of Interventional Radiology, Kaunas, Lithuania 3 Hospital of Lithuanian University of Health Sciences, department of Radiology, Kaunas, Lithuania
Background and aim: Stroke is the second main reason for death worldwide . Patients with atrial fibrillation have an increased ischemic stroke risk. Therefore, they are anticoagulated to reduce thromboembolic event chance . Al- though anticoagulation is associated with haemorrhage complications, there is little information about the safety and the outcomes of treating acute ischemic stroke with mechanical thrombectomy in patients with elevated international normalised ratio (INR) . This trial aimed to find out if there are differences in safety and outcomes in patients with elevated INR when treating acute ischemic stroke with mechanical thrombectomy.
Materials and methods: 183 cases were divided into two groups: patients with INR < 1.2 and patients with INR ≥ 1.2. Age and gender distribution were evaluated. Intracranial haemorrhage and mortality rates were analysed. Four patho- logical changes (signs of acute ischemia, haemorrhage transformations, deformations in the ventricular system, and the midline shift) in non-contrast CT scans before the mechanical thrombectomy and 24 hours after the thrombectomy were analysed.
Results: Results revealed that there was no statistical significance between the groups in intracranial haemorrhage (p = 0.292) or morality (p = 0.345) rates. Several pathological changes before the mechanical thrombectomy (p = 0.631) and 24 hours after mechanical thrombectomy (p = 0.398) were not statistically significantly different. In 24 hours, the study group did not develop (p = 0.548) a statistically significant number of new pathological changes when comparing to the control group.
Conclusion: Mechanical thrombectomy safety and outcomes when treating acute ischemic stroke in patients with ele- vated INR did not differ from patients who had regular INR.
Keywords: Acute ischemic stroke, non-contrast CT, mechanical thrombectomy, safety, elevated INR.