Endovascular Treatment of Large Vessel Occlusion Strokes Caused by Infective Endocarditis: A Systematic Review,

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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
09:21

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke

Published on: January 18, 2018

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Ashkan Mowla1, Saeed Abdollahifard2, Saman Sizdahkhani1

  • 1Division of Stroke and Endovascular Neurosurgery, Department of Neurological Surgery, Keck School of Medicine, University of Southern California (USC), Los Angeles, CA 90089, USA.

Life (Basel, Switzerland)
|December 23, 2022
PubMed

Insights

Mechanical thrombectomy may be a safe and effective treatment for acute ischemic strokes caused by infective endocarditis (IE). This procedure may reduce stroke severity, although further large-scale studies are needed.

Area of Science:

  • Neurology
  • Cardiology
  • Interventional Radiology

Background:

  • Infective endocarditis (IE) frequently leads to thromboembolic events, including acute ischemic strokes.
  • Intravenous thrombolytics are often contraindicated in IE patients due to increased intracranial hemorrhage risk.
  • Mechanical thrombectomy presents a potential alternative for large vessel occlusion (LVO) strokes in this population.

Purpose of the Study:

  • To systematically review and meta-analyze the outcomes and safety of mechanical thrombectomy for LVO stroke patients with IE.
  • To assess the efficacy and safety profile of mechanical thrombectomy in this specific patient group.

Main Methods:

  • A systematic literature search was conducted across PubMed, Scopus, Web of Science, and Embase.
  • Keywords included "infective endocarditis", "stroke", and "mechanical thrombectomy".
  • Data from 6 studies involving 120 patients were pooled for analysis.

Main Results:

  • Mechanical thrombectomy showed a potential reduction in NIH Stroke Scale (NIHSS) scores (WMD: -3.06; 95% CI: -4.43 to -1.70).
  • The pooled rate of symptomatic intracranial hemorrhage was 15% (95% CI: 4-47%).
  • The pooled rate of all-cause mortality was 34% (95% CI: 14-61%).

Conclusions:

  • Mechanical thrombectomy appears to be an effective and reasonably safe treatment option for large vessel occlusion strokes secondary to infective endocarditis.
  • Further large-scale research is warranted to confirm these findings and establish definitive treatment guidelines.

Keywords:
infective endocarditislarge vessel occlusionmechanical thrombectomystroke

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