A Comparison of Mechanical Thrombectomy for Large Vessel Occlusion in Acute Ischemic Stroke between Patients with and without Atrial Fibrillation

Abstract

Objective: Atrial fibrillation (AF) is one of the major risk for large vessel acute ischemic stroke. Mechanical thrombectomy is a promising therapeutic adjunct for large vessel occlusion and also the option for patients who missed the golden time window or who have contraindications for intravenous recombinant tissue plasminogen activator (rtPA). The purpose of this study was to investigate whether AF is a prognostic predictor for the patients with ischemic stroke undergoing mechanical thrombectomy. Methods: Medical records of all patients with acute ischemic stroke (AIS) caused by large vessel occlusion (LVO) who received mechanical thrombectomy at Siriraj Hospital between November 2009 and November 2016 were retrospectively reviewed. Clinical parameters between the two groups were retrieved and compared. Results: One hundred and thirty -eight acute ischemic stroke (AIS) patients were treated by endovascular mechanical thrombectomy at Siriraj Hospital between November 2009 and November 2016. Five patients lost from the follow-up process. Totally, 134 patients were included to this study. Fifty patients (37.3%) were in the AF group, 10 patients (7.5%) had a newly diagnosed AF. The AF patients were younger (p=0.002) and had less intracranial atherosclerosis (p=0.015) than non-AF patients. Nevertheless, gender, mean NIHSS, the mean time form puncture to recanalization, mean onset to recanalization, number of the passing of the stent, TICI, symptomatic intracranial hemorrhage, good clinical outcome at 90 days, and mortality rate were not different between two groups. Conclusion: There is no significant difference of good outcome and complications between AF and non-AF patients with AIS from LVO who underwent mechanical thrombectomy.

Keywords

• Acute ischemic stroke;
• atrial fibrillation;
• mechanical thrombectomy
• (Siriraj Med J 2018;70: 278-283)