Early Antiplatelet Therapy With Mechanical Thrombectomy Shows Benefits

Early use tied to better postoperative functional outcomes without hemorrhagic transformation risk
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Medically Reviewed By:
Mark Arredondo, M.D.

TUESDAY, Aug. 15, 2023 (HealthDay News) -- Early use of antiplatelet treatment after mechanical thrombectomy (MT) for acute ischemic stroke is associated with better functional outcomes without safety concerns, according to a study presented at the annual meeting of the Society of NeuroInterventional Surgery, held from July 31 to Aug 4 in San Diego.

Hepzibha Alexander, M.D., from Ascension Providence Hospital in Southfield, Michigan, and colleagues evaluated the safety and functional outcomes of antiplatelet use within 24 hours following MT. Analysis included prospective data for 190 consecutive patients who underwent MT for acute ischemic stroke (2016 to 2020).

The researchers found significant differences between the early and late groups for sex (61.1 percent versus 38.3 percent male), preoperative tissue plasminogen activator (24.2 versus 75.8 percent), angioplasty (23.2 versus 2.1 percent) and/or stent placement (20.0 versus 2.1 percent) and thrombectomy site (83.1 versus 97.9 percent anterior and 16.8 versus 2.1 percent posterior circulation). There was no significant difference seen between the groups for hemorrhagic transformation (symptomatic and asymptomatic) or inpatient mortality. At discharge, 30 days, and 90 days in the early group, modified Rankin scale score was significantly lower. In the early antiplatelet group, functional independence was significantly higher at discharge and at 30 days. Early antiplatelet use was independently associated with significantly higher odds of achieving functional independence at discharge (odds ratio, 3.07) and 30 days (odds ratio, 5.78). There was no independent association noted between early antiplatelet and increased odds of hemorrhagic transformation.

"Continuously working to improve patient outcomes is one of our top priorities," Alexander said in a statement. "Finding a new way to safely use this already-essential medication is an exciting step forward in helping patients thrive after stroke."


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