NDLI: Intracranial hemorrhage, outcome, and mortality after intra-arterial therapy for acute ischemic stroke in patients under oral anticoagulants.

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Intracranial hemorrhage, outcome, and mortality after intra-arterial therapy for acute ischemic stroke in patients under oral anticoagulants.

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Intracranial hemorrhage, outcome, and mortality after intra-arterial therapy for acute ischemic stroke in patients under oral anticoagulants.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Colucci, Giuseppe Galimanis, Aekaterini Arnold, Marcel Jung, Simon Mattle, Heinrich P. Fischer, Urs Gralla, Jan Schroth, Gerhard De Marchis, Gian Marco Brekenfeld, Caspar Mono, Marie-Luise Meier, Niklaus Weck, Anja
Description	Country affiliation: Switzerland Author Affiliation: De Marchis GM ( Department of Neurology, Inselspital, University of Bern, Freiburgstrasse 10, 3010 Bern, Switzerland.)
Abstract	BACKGROUND AND PURPOSE: Use of intravenous tissue-type plasminogen activator (IV tPA) for acute ischemic stroke is restricted to patients with an international normalized ratio (INR) less than 1.7. However, a recent study showed increased risk of symptomatic intracranial hemorrhage after IV tPA use in patients with oral anticoagulants (OAC) even with an INR less than 1.7. The present study assessed the risk of symptomatic intracranial hemorrhage, clinical outcome, and mortality after intra-arterial therapy (IAT) in patients with and without previous use of OAC. METHODS: Consecutive patients treated with IAT from December 1992 to October 2010 were included. Clinical outcome and mortality were assessed 90 days after stroke onset. Patients with and without previous use of OAC were compared. RESULTS: Overall, 714 patients were treated with IAT. Twenty-eight patients (3.9%) were under OAC at time of symptom onset. Median INR in the OAC group was 1.79 (interquartile range [IQR], 1.41-2.3) and 1.01 (IQR, 1.0-1.09; P<0.0001) in the group without OAC. Patients treated with OAC at admission underwent more often mechanical-only IAT than did patients without OAC (46.4% versus 12.8%; P<0.0001). Comparing patients with and without previous use of OAC, we did not find any statistical difference in the rate of symptomatic intracranial hemorrhage (7.1% versus 6.0%; P=0.80), unfavorable outcome (modified Rankin Scale score, 3-6; 67.9% versus 50.9%; P=0.11), and mortality (17.9% versus 21.6%; P=0.58). CONCLUSIONS: Previous use of OAC did not significantly increase the risk of symptomatic intracranial hemorrhage after IAT or the risk of unfavorable outcome and mortality 90 days after IAT.
ISSN	00392499
e-ISSN	15244628
Journal	Stroke
Issue Number	11
Volume Number	42
Language	English
Publisher	Lippincott Williams & Wilkins (on behalf of the American Heart Association)
Publisher Date	2011-11-01
Publisher Place	United States
Access Restriction	Open
Subject Keyword	Anticoagulants Administration & Dosage Brain Ischemia Mortality Intracranial Hemorrhages Stroke Thrombolytic Therapy Tissue Plasminogen Activator Administration, Oral Drug Therapy Cohort Studies Infusions, Intra-arterial Retrospective Studies Comparative Study Discipline Cardiology
Content Type	Text
Resource Type	Article
Subject	Cardiology and Cardiovascular Medicine Neuroscience Advanced and Specialized Nursing Neurology (clinical)

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