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Peri-procedural decrease in hemoglobin following mechanical thrombectomy for ischemic stroke.

Huanwen Chen1,2, Ghasan Ahmad1, Michael S Phipps3

  • 1Division of Interventional Neuroradiology, Department of Radiology, University of Maryland Medical Center, Baltimore, MD, USA.

Interventional Neuroradiology : Journal of Peritherapeutic Neuroradiology, Surgical Procedures and Related Neurosciences
|October 5, 2023
PubMed
Summary
This summary is machine-generated.

Mechanical thrombectomy for stroke can cause blood loss and anemia. More passes and longer times increase hemoglobin drop, raising risks for poor outcomes and death.

Keywords:
Anemiapassesstrokethrombectomy

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Area of Science:

  • Neurology
  • Interventional Neuroradiology
  • Critical Care Medicine

Background:

  • Mechanical thrombectomy (MT) for ischemic stroke can lead to peri-procedural blood loss and hemodilution.
  • The relationship between blood loss, MT procedural factors, and clinical outcomes remains unclear.

Purpose of the Study:

  • To investigate the association between peri-procedural hemoglobin changes during MT and procedural characteristics.
  • To determine the impact of new-onset severe anemia on clinical outcomes after MT.

Main Methods:

  • A retrospective analysis of 445 patients undergoing MT for anterior circulation large-vessel occlusion.
  • Hemoglobin levels before and after MT were analyzed; new-onset severe anemia was defined as post-MT hemoglobin < 10 g/dL.
  • Modified Rankin Scale (mRS) at 90 days was used to assess clinical outcomes.

Main Results:

  • Average hemoglobin decrease post-MT was 1.27 g/dL.
  • Increased thrombectomy passes and longer procedure times correlated with greater hemoglobin decrease (p < 0.001 and p = 0.002).
  • New-onset severe anemia occurred in 11.5% of patients and was linked to higher rates of poor 90-day outcomes (mRS 3-6) and death (OR 2.70 and 2.73, respectively).

Conclusions:

  • Peri-procedural hemoglobin decrease is associated with MT procedural intensity.
  • Patients developing severe anemia post-MT face significantly increased risks of poor clinical outcomes and mortality.