Long-Term Benefit of Mechanical Thrombectomy for Acute Ischemic Stroke in Patients with a Left Ventricular Assist Device: A Single-Center Retrospective Study.

Abstract

OBJECTIVE:

Left ventricular assist devices (LVADs) are an epoch-making treatment option for patients with severe heart failure; however, the patients occasionally experience severe acute ischemic strokes (AISs). Although mechanical thrombectomy is considered as an effective treatment for severe AIS in patients with LVADs, there remains a paucity of data on the long-term outcomes. This study aimed to investigate the acute-phase efficacy and long-term outcomes of mechanical thrombectomy for AIS patients with LVADs.

METHODS:

We retrospectively reviewed 9 cases in 8 patients with LVADs who developed AIS and underwent mechanical thrombectomy from July 2014 to November 2021 at our hospital. Clinical information, including the National Institutes of Health Stroke Scale score and modified Rankin Scale score before and after thrombectomy, the details of procedures, and the long-term outcomes after thrombectomy, was retrospectively reviewed and statistically analyzed.

RESULTS:

Effective recanalization was achieved in 89% of the 9 cases. The median National Institutes of Health Stroke Scale score improved from 12 (range, 8-29) to 5 (range, 0-29) after mechanical thrombectomy. The median total follow-up duration was 1327 (range, 78-2659) days. Of the 8 patients, 3 patients underwent heart transplantation, and the LVAD was removed after recovery of the patient's heart function. One patient awaited heart transplantation.

CONCLUSIONS:

This study revealed the long-term benefit of mechanical thrombectomy for AIS in patients with LVADs, eventually achieving 50% of independence from LVADs.

• Authors: Shinji Kawamura, Satoshi Koizumi, Motoyuki Umekawa, Satoru Miyawaki, Osamu Kinoshita, Minoru Ono, Nobuhito Saito
• Journal: World neurosurgery (World Neurosurg) Vol. 165 Pg. e331-e336 (09 2022) ISSN: 1878-8769 [Electronic] United States
• PMID: 35718273 (Publication Type: Journal Article)
• Copyright: Copyright © 2022 Elsevier Inc. All rights reserved.

Topics

• Brain Ischemia (etiology)
• Heart-Assist Devices (adverse effects)
• Humans
• Ischemic Stroke
• Retrospective Studies
• Stroke (etiology)
• Thrombectomy (methods)
• Treatment Outcome