Key result
In patients undergoing endovascular thrombectomy, prior vitamin K antagonist use did not increase overall risk of symptomatic intracranial hemorrhage, but an INR >1.7 significantly increased this risk.
Why the study?
Does endovascular thrombectomy increase the risk of symptomatic intracranial hemorrhage in ischemic stroke patients with recent vitamin K antagonist use?
Does endovascular thrombectomy increase the risk of symptomatic intracranial hemorrhage in ischemic stroke patients with recent vitamin K antagonist use?
While endovascular thrombectomy appears safe overall in patients with recent vitamin K antagonist use, those presenting with an INR > 1.7 face a significantly increased risk of symptomatic intracranial hemorrhage.
A recent study by Brian Mac Grory and colleagues investigated the safety of endovascular thrombectomy (EVT) among patients under vitamin K antagonists (VKAs) use within 7 days prior to hospital admission. Through this retrospective, observational cohort study, they found prior VKA use did not increase the risk of symptomatic intracranial hemorrhage (sICH) overall. However, recent VKA use with a presenting international normalized ratio (INR) > 1.7 was associated with a significantly increased risk of sICH. Future large-scale randomized controlled trials should be conducted to further clarify the effects and feasibility of EVT therapy in ischemic stroke patients under anticoagulation.
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Gao et al. (2024) conducted an editorial in Ischemic stroke. Vitamin K antagonists (VKAs) use within 7 days prior to hospital admission was evaluated on Symptomatic intracranial hemorrhage (sICH). In patients undergoing endovascular thrombectomy, prior vitamin K antagonist use did not increase overall risk of symptomatic intracranial hemorrhage, but an INR >1.7 significantly increased this risk.
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