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Mechanical Thrombectomy in Acute Ischemic Stroke COVID-19 and Non-COVID-19 Patients: A Single Comprehensive Stroke

Sanja Lovrić Kojundžić1,2,3, Sara Sablić1, Danijela Budimir Mršić1,2,3

  • 1Department of Diagnostic and Interventional Radiology, University Hospital of Split, 21000 Split, Croatia.

Life (Basel, Switzerland)
|January 21, 2023
PubMed

Insights

Mechanical thrombectomy (MT) is effective for acute ischemic stroke (AIS) in COVID-19 patients. Outcomes were similar between COVID-19 and non-COVID-19 patients, despite differing clinical markers.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Cardiovascular Medicine

Background:

  • Coronavirus disease 2019 (COVID-19) is linked to an increased risk of thromboembolic events, including acute ischemic stroke (AIS).
  • Mechanical thrombectomy (MT) is a primary treatment for AIS, but its efficacy in COVID-19 patients remains debated due to conflicting reports.

Purpose of the Study:

  • To compare the outcomes of mechanical thrombectomy (MT) in patients with acute ischemic stroke (AIS) who had COVID-19 versus those without the infection.
  • To analyze clinical and laboratory differences and treatment approaches between COVID-19 and non-COVID-19 patients undergoing MT for AIS.

Main Methods:

  • A retrospective analysis of 68 patients (13 COVID-19, 55 non-COVID-19) who underwent MT for AIS between April 2021 and April 2022.
  • Comparison of baseline clinical and laboratory data, reperfusion success (modified Thrombolysis in Cerebral Infarction scale), and functional outcomes (modified Rankin scale) at 24-hour follow-up CT.

Main Results:

  • COVID-19 patients exhibited higher leukocytes, neutrophils, neutrophil/leukocyte ratios, ASL, ALT, LDH, CRP, and lower lymphocytes compared to controls.
  • AIS predominantly affected posterior circulation in the COVID-19 group, whereas anterior circulation was more impacted in the non-COVID-19 group.
  • No significant differences were observed in treatment approaches or successful reperfusion rates between the COVID-19 and control groups.

Conclusions:

  • Despite distinct clinical and laboratory profiles, mechanical thrombectomy yields comparable outcomes for acute ischemic stroke in patients with and without COVID-19.
  • COVID-19 patients with AIS showed specific inflammatory markers and a predilection for posterior circulation stroke.
  • MT remains an effective treatment for AIS, irrespective of COVID-19 status, with similar reperfusion success and functional outcomes.

Keywords:
COVID-19acute ischemic strokemechanical thrombectomyneutrophil/lymphocyte ratio

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