Journal article
Endovascular management of acute large vessel occlusion stroke in pregnancy is safe and feasible
Journal of neurointerventional surgery, Vol.12(6), pp.552-556
06/2020
DOI: 10.1136/neurintsurg-2019-015578
PMID: 31801850
Abstract
IntroductionStroke is a leading cause of adult death and disability. Although acute ischemic stroke (AIS) in pregnancy is rare, it has devastating consequences on the life of the mother and fetus. Pregnancy was an exclusion criterion in endovascular thrombectomy (EVT) trials and so there are no evidence-based treatment recommendations in this subgroup. The objective of this study was to evaluate the safety and feasibility of mechanical thrombectomy in large vessel occlusion (LVO) stroke in pregnancy.MethodsPatients with AIS due to LVO treated with EVT during pregnancy between 2000 and 2019 were identified at seven tertiary care centers. After IRB approval, retrospective analysis of prospectively maintained stroke/endovascular databases was performed.ResultsA total of seven subjects were identified. The average age was 33.2 years (range 25–38 years) and the average initial National Institutes of Health Stroke Scale (NIHSS) score at presentation was 15 (range 9–28). Three patients received IV tissue plasminogen activator. Techniques of EVT included stent retriever thrombectomy, stent retriever-assisted continuous aspiration, direct contact aspiration, and multimodal techniques including a rescue balloon mounted coronary stent placement. While one patient was noted to have petechial hemorrhage, no individuals developed parenchymal hematoma. Mean discharge NIHSS score was 1.7 (range 0–5).ConclusionEVT is a safe and effective treatment for acute stroke secondary to LVO in this series of pregnant patients. While EVT for acute stroke is standard of care in select patient populations, our study suggests that treatment should be considered in the gravid population.
Details
- Title: Subtitle
- Endovascular management of acute large vessel occlusion stroke in pregnancy is safe and feasible
- Creators
- Kaustubh Limaye - University of IowaAnn Van de Walle Jones - Roy J. and Lucille A. Carver College of MedicineAmir Shaban - University of IowaShashvat Desai - University of PittsburghSami Al Kasab - Medical University of South CarolinaEyad Almallouhi - Medical University of South CarolinaChristine A Holmstedt - Medical University of South CarolinaSantiago Ortega-Gutierrez - University of IowaDiogo C Haussen - Grady Memorial HospitalRaul Nogueira - Grady Memorial HospitalFrancisco Mont’Alverne - Hospital Geral de FortalezaCarlos Ragiotto - Hospital das Clínicas Samuel LibânioLeticia C Rebello - Grady Memorial HospitalTudor G Jovin - Cooper University HospitalDavid Hasan - University of IowaAshutosh Jadhav - University of Pittsburgh
- Resource Type
- Journal article
- Publication Details
- Journal of neurointerventional surgery, Vol.12(6), pp.552-556
- DOI
- 10.1136/neurintsurg-2019-015578
- PMID
- 31801850
- NLM abbreviation
- J Neurointerv Surg
- ISSN
- 1759-8478
- eISSN
- 1759-8486
- Language
- English
- Date published
- 06/2020
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Neurology; Radiology; Iowa Neuroscience Institute; Neurosurgery
- Record Identifier
- 9984302210802771
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