ArticleFrontiers in neurology2018
Periprocedural Antithrombotic Treatment During Acute Mechanical Thrombectomy for Ischemic Stroke: A Systematic Review.
Article in Frontiers in neurology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
21 citing papers in PubMed, 47 citations in OpenAlex.
- Prior antiplatelet therapy in patients undergoing endovascular treatment for acute ischemic stroke: Results from the MR CLEAN Registry.International journal of stroke : official journal of the International Stroke Society · 2021Trial
- The safety and efficacy of anti-thrombotic agents during mechanical thrombectomy procedure for acute ischemic stroke: A systematic review and meta-analysis.Journal of cerebrovascular and endovascular neurosurgery · 2026Article
- Periprocedural unfractionated heparin bolus during endovascular treatment in acute ischemic stroke does more harm than good.Journal of neurointerventional surgery · 2024Article
- Management of Incomplete Microcirculatory Reperfusion After Endovascular Thrombectomy: Focus on Inhibition of the Glycoprotein IIb/IIIa Receptor Pathway.Stroke (Hoboken, N.J.) · 2024Review
- Update of Anticoagulation Use in Cardioembolic Stroke With a Special Reference to Endovascular Treatment.Journal of stroke · 2024Review
- Conservative versus aggressive antiplatelet strategy for emergent carotid stenting during stroke thrombectomy.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2023Article
- Effects of prior antiplatelet use on futile reperfusion in patients with acute ischemic stroke receiving endovascular treatment.European stroke journal · 2023Article
- P2Y12 inhibitors for the neurointerventionalist.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2022Review
- Cervical carotid occlusion in acute ischemic stroke: Should we give tPA?Surgical neurology international · 2022Article
- Antithrombotic Therapy in the Prevention of Stroke.Biomedicines · 2021Review
- Utility of Hounsfield unit in the diagnosis of tandem occlusion in acute ischemic stroke.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2021Article
- Complication Rates Using CASPER Dual-Layer Stents for Carotid Artery Stenting in Acute Stroke : A 3-Year Single Center Experience.Clinical neuroradiology · 2021Article
- Safety and efficacy of oral antiplatelet for patients who had acute ischaemic stroke undergoing endovascular therapy.Stroke and vascular neurology · 2020Article
- Carotid Stenting and Mechanical Thrombectomy in Patients with Acute Ischemic Stroke and Tandem Occlusions: Antithrombotic Treatment and Functional Outcome.AJNR. American journal of neuroradiology · 2020Article
- Article
- Treatment Strategies for Tandem Occlusions in Acute Ischemic Stroke.Seminars in interventional radiology · 2020Review
- Antiplatelet therapy within 24 hours of tPA: lessons learned from patients requiring combined thrombectomy and stenting for acute ischemic stroke.Journal of cerebrovascular and endovascular neurosurgery · 2020Article
- Therapeutic effect of pre-operative tirofiban on patients with acute ischemic stroke with mechanical thrombectomy within 6-24 hours.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2019Article
- [Periinterventional management of acute endovascular stroke treatment].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2019Review
- Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 2 countries.
Funding
Abstract
backgroundMore than one-third of the patients with ischemic stroke caused by an intracranial large vessel occlusion do not recover to functional independence despite fast and successful recanalization by acute mechanical thrombectomy (MT). This may partially be explained by incomplete microvascular reperfusion. Some antithrombotics, e.g., antiplatelet agents and heparin, may be able to restore microvascular reperfusion. However, antithrombotics may also increase the risk of symptomatic intracranial hemorrhage (sICH). The aim of this review was to assess the potential safety and functional outcome of periprocedural antiplatelet or heparin use during acute MT for ischemic stroke.
methodsWe systematically searched
results837 studies were identified through the search, of which 19 studies were included. The sICH risks of the periprocedural use of antiplatelets ranged from 6 to 17%, and for heparin from 5 to 12%. Two of four studies reporting relative effects of the use of antithrombotics are pointing toward an increased risk of sICH. Among patients treated with antiplatelet agents, functional independence varied from 23 to 60% and mortality from 18 to 33%. For heparin, this was, respectively, 19-54% and 19-33%. The three studies presenting relative effects of antiplatelets on functional independence showed neutral effects. Both studies reporting relative effects of heparin on functional independence found it to increase this chance.
conclusionRandomized controlled trials investigating the effect of periprocedural antithrombotic treatment in MT are lacking. Some observational studies report a slight increase in sICH risk, which may be acceptable because they also suggest a beneficial effect on functional outcome. Therefore, randomized controlled trials are warranted to address the question whether the potentially higher risk of sICH could be outweighed by improved functional outcome.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.