Periprocedural heparin use in acute ischemic stroke endovascular therapy: the TREVO 2 trial

Journal of Neurointerventional Surgery
Melanie J WinninghamFadi Nahab

Abstract

The use of periprocedural heparin has previously been reported to be safe and potentially beneficial during thrombectomy with older generation devices. We aimed to evaluate the safety and clinical outcomes of heparin use in the stent retriever era. A post hoc analysis of the TREVO 2 trial was performed comparing baseline characteristics and clinical outcomes between patients who received (HEP+) and those who did not receive periprocedural heparin (HEP-) while undergoing MERCI or TREVO clot retrieval. Of 173 patients, 58 (34%) received periprocedural heparin including 40 who received one preprocedural bolus (median 3000 units). Baseline characteristics among HEP+ and HEP- patients were similar except HEP+ patients had a lower NIH Stroke Scale (NIHSS) score (17 vs 19; p=0.04), lower IV tissue plasminogen activator use (38% vs 64%; p<0.01), and a higher median ASPECTS score (8.0 vs 7.0; p=0.02). HEP+ patients were more likely to have vertebrobasilar and middle cerebral artery (MCA)-M1 occlusions but less likely to have internal carotid artery and MCA-M2 occlusions (p=0.04). Time from symptom onset to puncture was similar in the two groups while procedure duration was longer in HEP+ patients (99 vs 83 min; p<0.01). Thrombolysis In ...Continue Reading

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Citations

Jun 4, 2019·Cardiovascular and Interventional Radiology·François ZhuUNKNOWN TITAN (Thrombectomy In TANdem Lesions) Investigators
Dec 21, 2019·Stroke; a Journal of Cerebral Circulation·Rob A van de GraafUNKNOWN Coinvestigators MR CLEAN Registry
Nov 10, 2018·Interventional Neurology·Diogo C HaussenRaul G Nogueira
Jan 5, 2021·Cardiovascular and Interventional Radiology·Faysal BenaliUNKNOWN MR CLEAN REGISTRY investigators
Jul 25, 2020·JACC. Cardiovascular Interventions·Estêvão Carvalho de Campos MartinsFausto Castriota

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