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Treatment of Acute Ischemic Stroke due to Large Vessel Occlusion With COVID-19: Experience From Paris

Simon Escalard1, Benjamin Maïer1, Hocine Redjem1

  • 1From the Interventional Neuroradiology Department, Rothschild Foundation Hospital, Paris, France.

Stroke
|May 30, 2020
PubMed

Insights

COVID-19 patients with acute ischemic stroke due to large vessel occlusion (LVO) experienced poor outcomes despite timely treatment. Further research into alternative pharmacological approaches is needed for these high-risk stroke patients.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Cardiovascular Research

Background:

  • Coronaviruses disease 2019 (COVID-19) is associated with increased stroke incidence.
  • Limited data exist on outcomes for COVID-19 patients experiencing acute ischemic stroke due to large vessel occlusion (LVO).

Purpose of the Study:

  • To report initial experiences and outcomes of treating acute ischemic stroke with LVO in COVID-19 patients.

Main Methods:

  • Retrospective analysis of 10 consecutive COVID-19 patients with acute ischemic stroke due to LVO.
  • Evaluation of clinical and radiological findings, treatments (intravenous alteplase, mechanical thrombectomy), and short-term outcomes.

Main Results:

  • Six out of ten patients (60%) died in the hospital.
  • Successful recanalization was achieved in 90% of patients, but 40% experienced early cerebral reocclusion.
  • No patients showed early neurological improvement despite prompt interventions.

Conclusions:

  • Standard best medical care, including mechanical thrombectomy, yielded poor outcomes in COVID-19 patients with LVO stroke.
  • Investigating alternative pharmacological strategies is crucial to address COVID-19-associated inflammatory and coagulation disorders in stroke management.
Abstract

Keywords:
COVID-19coagulation disorderoutbreakstrokethrombectomy

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