Title:Safety of Mechanical Thrombectomy for Acute Ischemic Stroke in Patients with Thrombocytopenia
Volume: 21
Issue: 3
Author(s): Sujie Zheng, Fang Liu, Liang Yu, Xinzhao Jiang, Xiaoyan Wen, Xu Wang and Zongjie Shi*
Affiliation:
- Department of Neurology, Center for Rehabilitation Medicine, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, 310014, China
Keywords:
Acute ischemic stroke, mechanical thrombectomy, neurointervention, sICH, large-vessel occlusion stroke, atrial fibrillation.
Abstract:
Background and Aim: The impact of low platelet count on outcomes in patients with
Acute Ischemic Stroke (AIS) undergoing Mechanical Thrombectomy (MT) is still unclear. In this
study we have further explored the effect of thrombocytopenia on the safety and efficacy of MT in
patients with anterior circulation Large Vessel Occlusion (LVO) stroke.
Materials and Methods: Patients with AIS who underwent MT at our center between June 2015
and November 2021 were examined. Based on the platelet count recorded on admission patients
were divided into two groups: those with thrombocytopenia (<150 × 109/L) and those without
thrombocytopenia (≥ 150 × 109/L). Symptomatic Intracranial Hemorrhage (sICH) was the primary
safety outcome. The efficacy outcome was functional independence defined as a 90-day modified
Rankin Scale (mRS) score of 0-2. Multivariate logistic regression models were used to determine
the risk factors for post-procedure sICH and 90-day functional outcomes.
Results: Among 302 patients included in the study, thrombocytopenia was detected in 111
(36.8%) cases. Univariate analysis showed age, the proportion of atrial fibrillation, the rates of
sICH, 90-day poor outcomes, and mortality to be higher in patients with thrombocytopenia (all p
<0.05). Multivariable analysis showed thrombocytopenia to be independently associated with a
higher rate of sICH (OR 2.022, 95% CI 1.074-3.807, p =0.029) however, thrombocytopenia did
not affect the 90-day functional outcomes (OR 1.045, 95%CI 0.490-2.230, p =0.909) and mortality
(OR 1.389, 95% CI 0.467– 4.130 p = 0.554).
Conclusion: Thrombocytopenia may increase the risk of sICH but not affect the 90-day functional
outcomes and mortality in patients with AIS treated with MT.
