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Stroke and Mechanical Circulatory Support in Adults
David J Bae1, Joshua Z Willey2, Chinwe Ibeh3
1Division of Medicine, Center for Advanced Cardiac Care, Columbia University, New York, NY, USA.
Current Cardiology Reports
|November 3, 2023
Summary
Mechanical circulatory support (MCS) devices save lives but increase stroke risk. Management and prevention strategies are crucial for reducing stroke complications in patients with heart failure.
Area of Science:
- Cardiology
- Neurology
- Medical Devices
Background:
- Mechanical circulatory support (MCS) devices are vital for cardiogenic shock and end-stage heart failure.
- These devices improve cardiac output but are linked to significant stroke risks (ischemic and hemorrhagic).
Purpose of the Study:
- To review the epidemiology, risk factors, and treatment of stroke in patients using MCS devices.
- To discuss current understanding and management of stroke complications associated with MCS.
Main Methods:
- Literature review focusing on stroke in patients with short-term and durable MCS.
- Analysis of recent findings on stroke incidence, risk factors, and treatment strategies.
Main Results:
- MCS use is associated with high rates of ischemic and hemorrhagic strokes, leading to significant morbidity and mortality.
- While newer devices reduce ischemic stroke risk, hemorrhagic stroke remains a concern.
- Limited data exist for stroke treatment, but case series suggest benefits from thrombectomy and anticoagulation reversal.
Conclusions:
- Stroke in MCS patients carries high risks; prevention and management are critical.
- Preventive strategies should be tailored to specific MCS types.
- Further research is needed to optimize stroke management in this vulnerable population.
