What is the clinical evidence from this study?

Study design: Observational. Population: Large vessel occlusion (LVO) ischemic stroke (n=243). Intervention: Atrial fibrillation etiology vs. Other etiologies (non-AF). Primary outcome: First-pass effect (p=<0.05).

What question did this study set out to answer?

Evaluate how atrial fibrillation as a thrombus source affects mechanical thrombectomy procedures and outcomes in ischemic stroke.

May 8, 2026Open Access

Abstract Number: Esoc2026a1454 Impact of Atrial Fibrillation as an Etiology of Acute Ischemic Stroke on the Effectiveness and Procedural Aspects of Mechanical Thrombectomy: A Thrombectomy-Capable Stroke Center Study

Q: What are the key findings of this study?

In patients with LVO ischemic stroke undergoing mechanical thrombectomy, atrial fibrillation etiology was associated with a higher first-pass effect (52.14% vs. 35.29%, p<0.05) compared to non-AF.

Q: What question did this study set out to answer?

Evaluate how atrial fibrillation as a thrombus source affects mechanical thrombectomy procedures and outcomes in ischemic stroke.

Key Result

In patients with LVO ischemic stroke undergoing mechanical thrombectomy, atrial fibrillation etiology was associated with a higher first-pass effect (52.14% vs. 35.29%, p<0.05) compared to non-AF.

Key Points

Evaluate how atrial fibrillation as a thrombus source affects mechanical thrombectomy procedures and outcomes in ischemic stroke.
Retrospective single-centre study with 306 patients from 2020-2025; 243 patients analyzed.
Patients divided into atrial fibrillation and other etiology groups; treated with standard SAVE technique.
Statistical analysis included U Mann-Whitney and Chi-square tests for various comparisons.
Patients with AF were older (mean age 73.35) and more frequently female (60%).
NIHSS scores were worse in AF group (mean 17.6) compared to others (15.85, p<0.05).
Higher first-pass effect in AF (52.14% vs. 35.29%, p<0.05) and less frequent technique switching (19.29% vs. 30.39%, p<0.05).

Study Design

Type

Observational

Multicenter

Structured PICO

Does atrial fibrillation etiology impact the procedural effectiveness and outcomes of mechanical thrombectomy in patients with large vessel occlusion ischemic stroke?

Population

243 patients with large vessel occlusion (LVO) ischemic stroke treated with mechanical thrombectomy (140 with atrial fibrillation, 103 with other etiologies)

Intervention

Mechanical thrombectomy for LVO stroke caused by atrial fibrillation

Comparator

Mechanical thrombectomy for LVO stroke caused by non-atrial fibrillation etiologies

Outcome

Procedural aspects including first-pass effect, technique switching, and time intervalssurrogate

In patients undergoing mechanical thrombectomy for LVO stroke, an atrial fibrillation etiology is associated with a higher first-pass effect and less need for technique switching, though overall clinical and radiological outcomes remain similar to non-AF etiologies.

Abstract

Abstract Background and aims The duration and ease of the mechanical thrombectomy procedure in cases of large vessel occlusion (LVO) ischemic stroke significantly influence both radiological and clinical outcomes. This study aims to evaluate the impact of a cardioembolic source of thrombus in cases where atrial fibrillation is the etiology of stroke, on the procedural aspects of mechanical thrombectomy. Methods Retrospective single-centre study. Population of 306 patients, treated 2020-2025 - 243 patients qualified into analysis. Group divided: 1) patients with AF (140); 2) with other etiologies. Default treatment - SAVE (aspiration + stentretriever). Switching of the technique, time intervals recorded. Results measured: mTICI, NIHSS, mRS. Statistics - U Mann-Whitney for continuous, Chi-square for categorical. Results Population: AF as the etiology of LVO: older than no-AF (73.35 vs. 64.04yrs, p0.001), females more (60% vs. 34.95%, p0.001). Arterial hypertension greater (93.57% vs. 81.55%, p0.05), rate of tobacco smoking lower (22.14% vs. 44.66%, p0.001). NIHSS worse in AF (mean: 17.6 vs. 15.85, p0.05). IVT lower (60% vs. 80.58%, p0.01) -anticoagulation. Procedural: No differences observed between groups in time intervals: groin-to-first pass, first pass-to-recanalization; in the percentage of patients treated under GA. First-pass effect was higher in AF (52.14% vs. 35.29%, p0.05), technique switching less frequent (19.29% vs. 30.39%, p0.05). No differences in number of passes, balloon guide catheter, SAVE, ADAPT, stent retriever alone. No differences in complications. No differences in mTICI, NIHSS, mRS. Conclusions In patients with LVO caused by AF - higher rate of FPE, lower necessity for technique switching. No differences in complications, radiological, clinical outcomes compared to non-AF. Conflict of interest Artur Dziadkiewicz: nothing to disclose

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Discussion

Authors

Artur Dziadkiewicz

Krzysztof Pawłowski

Michał Sulkowski

Journals

European Stroke Journal

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Kaszubsko-Pomorska Szkoła Wyższa

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Abstract Number: Esoc2026a1454 Impact of Atrial Fibrillation as an Etiology of Acute Ischemic Stroke on the Effectiveness and Procedural Aspects of Mechanical Thrombectomy: A Thrombectomy-Capable Stroke Center Study

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