Outcomes of mechanical thrombectomy after recent cardiovascular procedures: a multicenter descriptive cohort

Large vessel occlusions (LVOs) in ischemic stroke represent a critical challenge, particularly in the peri-procedural setting of cardiovascular procedures (CVPs). Mechanical thrombectomy (MT) is a well-established treatment for LVOs; however, its outcomes in patients following recent CVPs remain unclear.

This multicenter retrospective cohort study aimed to evaluate the outcomes of MT in patients with ischemic stroke occurring within 30 days of CVPs.

We analyzed data from four centers, including patients aged ≥18 years who underwent MT for LVO within 30 days of CVPs. CVPs included both surgical (e.g. CABG, valve replacement) and minimally invasive procedures (e.g. TAVR, PCI). Baseline characteristics, procedural metrics, and outcomes, including NIHSS and mRS scores, were collected. Statistical analyses were performed using R software.

Of 8,947 screened stroke patients, 27 met the inclusion criteria. The median age was 69 years (IQR 60-83), and 56% were male. Anterior circulation occlusions were present in 93% of cases, with a median baseline NIHSS score of 18 (IQR 14-21). Successful reperfusion (TICI ≥2b) was achieved in 85% of cases, with a median of one thrombectomy pass. At 90 days, 30% of patients achieved functional independence (mRS 0-2), while the mortality rate was 44%. Procedural complications were rare (3.7%).

MT in patients with peri-procedural LVO after CVPs demonstrates success but poor functional recovery compared with baseline. These findings highlight the need for prospective studies to identify patients who may benefit most from MT in this high-risk population.