Evidence map›Paper›PMID 41145687›Full record

Observational studyClinical neuroradiology2026

Association Between Direct Oral Anticoagulants and the Risk of Internal Carotid Artery Occlusion in Patients Eligible for Thrombectomy.

Sho Hanai, Masayuki Sato, Mikito Hayakawa, Hisayuki Hosoo, Go Ikeda, Yoshiro Ito, Aiki Marushima, Tomoji Takigawa, Wataro Tsuruta, Noriyuki Kato and 6 more

Abstract readMulticenter StudyObservational Study
PubMed Publisher
In one paragraph

Observational study in Clinical neuroradiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Sho HanaiDepartment of Neurosurgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, Japan.
Masayuki SatoDepartment of Neurosurgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, Japan. marchin16@yahoo.co.jp.ORCID http://orcid.org/0000-0001-8695-2966
Mikito HayakawaDepartment of Stroke and Cerebrovascular Diseases, University of Tsukuba Hospital, Tsukuba, Japan.
Hisayuki HosooDepartment of Stroke and Cerebrovascular Diseases, University of Tsukuba Hospital, Tsukuba, Japan.
Go IkedaDepartment of Neurosurgery, Dokkyo Medical University, Mibu, Tochigi, Japan.
Yoshiro ItoDepartment of Neurosurgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, Japan.
Aiki MarushimaDepartment of Neurosurgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, Japan.
Tomoji TakigawaDepartment of Neurosurgery, Dokkyo Medical University Saitama Medical Center, Koshigaya, Saitama, Japan.
Wataro TsurutaDepartment of Endovascular Neurosurgery, Toranomon Hospital, Minato, Tokyo, Japan.
Noriyuki KatoDepartment of Neurosurgery, Mito Medical Center, Ibaraki, Ibaraki, Japan.
Kazuya UemuraDepartment of Neurosurgery, Tsukuba Medical Center Hospital, Tsukuba, Ibaraki, Japan.
Kensuke SuzukiDepartment of Neurosurgery, Dokkyo Medical University Saitama Medical Center, Koshigaya, Saitama, Japan.
Yoji KomatsuDepartment of Neurosurgery, Hitachi General Hospital, Hitachi, Ibaraki, Japan.
Hiroshi YamagamiDepartment of Stroke and Cerebrovascular Diseases, University of Tsukuba Hospital, Tsukuba, Japan.
Eiichi IshikawaDepartment of Neurosurgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, Japan.
Yuji MatsumaruDepartment of Neurosurgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, Japan.

Funding

Support Program for Starting up Innovation Hub JPMJFR2112 (AM)
6 · The paper itself

Abstract

purposeDirect oral anticoagulants (DOACs) have equivalent efficacy and fewer complications than vitamin K antagonists (VKAs) and are widely used for atrial fibrillation. However, data on how DOACs affect mechanical thrombectomy (MT) and influence the occlusion site are limited. This study aimed to investigate the efficacy and safety of MT before DOAC administration and how DOAC influences the occlusion site eligible for MT.

methodsThe NeuroEndovascular and Management from Multicenter Observation to Build a PHILosophical Approach (NEMMOPHILA) study analyzed 331 patients treated between January 2015 and March 2019 who underwent MT. The primary outcome was modified Rankin scale (mRS) of 0-3 at discharge, and the secondary outcomes included in-hospital mortality, and parenchymal hemorrhage (PH).

resultOf the 331 patients, 39 had prior DOAC therapy, 25 had prior VKA therapy, and 267 had non- anticoagulant therapy (non-AC). The internal carotid artery (ICA) occlusion rate was significantly lower in the DOAC group (DOAC, 25.6%; VKA, 56.0%; non-AC, 45.3%; p = 0.030). No significant difference was found in the mRS at discharge (DOAC, 51.3%; VKA, 36.0%; non-AC, 50.9%; p = 0.354), mortality (DOAC, 7.5%; VKA, 7.9%; non-AC, 10.9%; p = 0.66), and PH (DOAC, 2.6%; VKA, 12.0%; non-AC, 9.0%; p = 0.362). Multiple regression analysis revealed that DOAC significantly reduced ICA occlusion (odds ratio, 0.429; 95% confidence interval, 0.195-0.943; p = 0.035).

conclusionPatients with prior DOAC had low ICA occlusion rates. DOAC administration history did not lead to mRS improvement at discharge and did not increase PH after MT.

Indexed as

AnticoagulantsCarotid Artery, InternalCarotid StenosisThrombectomyAdministration, OralAgedAged, 80 and overFemaleHospital MortalityHumansMaleMiddle AgedRetrospective StudiesRisk FactorsAnticoagulantsDirect oral anticoagulantHemorrhageInternal carotid arteryMechanical thrombectomyParenchymal

Identifiers

PMID41145687

What OpenQuestion holds

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Registered trials

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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.