title: Safety of Endovascular Thrombectomy in Patients Receiving Non-Vitamin K Antagonist Oral Anticoagulants.
abstract: OBJECTIVE
  Prospective data on the safety of endovascular thrombectomy in acute stroke patients on non-vitamin K antagonist oral anticoagulants are lacking.
  
  
  METHODS
  Prospective multicenter observational study. Patients with ischemic stroke undergoing thrombectomy with or without preceding thrombolysis were enrolled into the Registry of Acute Ischemic Stroke Under New Oral Anticoagulants. Baseline characteristics and functional outcome at 3 months were assessed. Hemorrhagic transformation and symptomatic intracranial hemorrhage were analyzed. Reperfusion was graded using the modified Thrombolysis in Cerebral Infarction score.
  
  
  RESULTS
  Of 28 patients treated with thrombectomy, 5 had received also systemic thrombolysis (18%). Intracranial hemorrhage was observed in 46%, but symptomatic intracranial hemorrhage occurred only in 1 patient. Successful reperfusion (Thrombolysis in Cerebral Infarction score, 2b-3) was achieved in 59%. At 3 months, 19% had a modified Rankin Scale score of 0 to 2, and mortality was 26%.
  
  
  CONCLUSIONS
  Thrombectomy in non-vitamin K antagonist oral anticoagulant patients seems safe although a comparatively high rate of asymptomatic hemorrhagic transformation was noted. Confirmation in larger prospective controlled cohorts is necessary.
  
  
  BACKGROUND
  URL: http://www.clinicaltrials.gov. Unique identifier: NCT01850797.
authors.affiliation: From the Departments of Neurology (J.C.P., T.R., S.K., P.A.R., R.V.) and Neuroradiology (M.W.), University Hospital Heidelberg, Heidelberg, Germany; Institute of Clinical Epidemiology and Biometry (K.H., P.U.H.), University of Würzburg, Würzburg, Germany; Department of Neurology, University Hospital Münster, Münster, Germany (R.D.); Department of Neurology (C.K.), and Comprehensive Heart Failure Center and Clinical Trial Center (P.U.H.), University Hospital Würzburg, Würzburg, Germany; Department of Neurology, University Hospital Kiel, Kiel, Germany (A.B.); Department of Neurology, University Hospital Mainz, Mainz, Germany (K.G.); Department of Neurology, University Hospital Mannheim, Mannheim, Germany (M.G.H.); Departments of Neuroradiology (K.L.) and Stroke Medicine (R.V.), Imperial College London, London, United Kingdom; Department of Neurology, University Hospital Tübingen, Tübingen, Germany (S.P.); Department of Neurology, Asklepios Klinik Nord, Hamburg, Germany (G.S.); and Department of Neurology, Klinikum Fulda, Fulda, Germany (T.N.-H.).
authors.forename: Jan C
authors.initials: JC
authors.lastname: Purrucker
authors.affiliation: From the Departments of Neurology (J.C.P., T.R., S.K., P.A.R., R.V.) and Neuroradiology (M.W.), University Hospital Heidelberg, Heidelberg, Germany; Institute of Clinical Epidemiology and Biometry (K.H., P.U.H.), University of Würzburg, Würzburg, Germany; Department of Neurology, University Hospital Münster, Münster, Germany (R.D.); Department of Neurology (C.K.), and Comprehensive Heart Failure Center and Clinical Trial Center (P.U.H.), University Hospital Würzburg, Würzburg, Germany; Department of Neurology, University Hospital Kiel, Kiel, Germany (A.B.); Department of Neurology, University Hospital Mainz, Mainz, Germany (K.G.); Department of Neurology, University Hospital Mannheim, Mannheim, Germany (M.G.H.); Departments of Neuroradiology (K.L.) and Stroke Medicine (R.V.), Imperial College London, London, United Kingdom; Department of Neurology, University Hospital Tübingen, Tübingen, Germany (S.P.); Department of Neurology, Asklepios Klinik Nord, Hamburg, Germany (G.S.); and Department of Neurology, Klinikum Fulda, Fulda, Germany (T.N.-H.).
authors.forename: Marcel
authors.initials: M
authors.lastname: Wolf
authors.affiliation: From the Departments of Neurology (J.C.P., T.R., S.K., P.A.R., R.V.) and Neuroradiology (M.W.), University Hospital Heidelberg, Heidelberg, Germany; Institute of Clinical Epidemiology and Biometry (K.H., P.U.H.), University of Würzburg, Würzburg, Germany; Department of Neurology, University Hospital Münster, Münster, Germany (R.D.); Department of Neurology (C.K.), and Comprehensive Heart Failure Center and Clinical Trial Center (P.U.H.), University Hospital Würzburg, Würzburg, Germany; Department of Neurology, University Hospital Kiel, Kiel, Germany (A.B.); Department of Neurology, University Hospital Mainz, Mainz, Germany (K.G.); Department of Neurology, University Hospital Mannheim, Mannheim, Germany (M.G.H.); Departments of Neuroradiology (K.L.) and Stroke Medicine (R.V.), Imperial College London, London, United Kingdom; Department of Neurology, University Hospital Tübingen, Tübingen, Germany (S.P.); Department of Neurology, Asklepios Klinik Nord, Hamburg, Germany (G.S.); and Department of Neurology, Klinikum Fulda, Fulda, Germany (T.N.-H.).
authors.forename: Kirsten
authors.initials: K
authors.lastname: Haas
authors.affiliation: From the Departments of Neurology (J.C.P., T.R., S.K., P.A.R., R.V.) and Neuroradiology (M.W.), University Hospital Heidelberg, Heidelberg, Germany; Institute of Clinical Epidemiology and Biometry (K.H., P.U.H.), University of Würzburg, Würzburg, Germany; Department of Neurology, University Hospital Münster, Münster, Germany (R.D.); Department of Neurology (C.K.), and Comprehensive Heart Failure Center and Clinical Trial Center (P.U.H.), University Hospital Würzburg, Würzburg, Germany; Department of Neurology, University Hospital Kiel, Kiel, Germany (A.B.); Department of Neurology, University Hospital Mainz, Mainz, Germany (K.G.); Department of Neurology, University Hospital Mannheim, Mannheim, Germany (M.G.H.); Departments of Neuroradiology (K.L.) and Stroke Medicine (R.V.), Imperial College London, London, United Kingdom; Department of Neurology, University Hospital Tübingen, Tübingen, Germany (S.P.); Department of Neurology, Asklepios Klinik Nord, Hamburg, Germany (G.S.); and Department of Neurology, Klinikum Fulda, Fulda, Germany (T.N.-H.).
authors.forename: Timolaos
authors.initials: T
authors.lastname: Rizos
authors.affiliation: From the Departments of Neurology (J.C.P., T.R., S.K., P.A.R., R.V.) and Neuroradiology (M.W.), University Hospital Heidelberg, Heidelberg, Germany; Institute of Clinical Epidemiology and Biometry (K.H., P.U.H.), University of Würzburg, Würzburg, Germany; Department of Neurology, University Hospital Münster, Münster, Germany (R.D.); Department of Neurology (C.K.), and Comprehensive Heart Failure Center and Clinical Trial Center (P.U.H.), University Hospital Würzburg, Würzburg, Germany; Department of Neurology, University Hospital Kiel, Kiel, Germany (A.B.); Department of Neurology, University Hospital Mainz, Mainz, Germany (K.G.); Department of Neurology, University Hospital Mannheim, Mannheim, Germany (M.G.H.); Departments of Neuroradiology (K.L.) and Stroke Medicine (R.V.), Imperial College London, London, United Kingdom; Department of Neurology, University Hospital Tübingen, Tübingen, Germany (S.P.); Department of Neurology, Asklepios Klinik Nord, Hamburg, Germany (G.S.); and Department of Neurology, Klinikum Fulda, Fulda, Germany (T.N.-H.).
authors.forename: Shujah
authors.initials: S
authors.lastname: Khan
authors.affiliation: From the Departments of Neurology (J.C.P., T.R., S.K., P.A.R., R.V.) and Neuroradiology (M.W.), University Hospital Heidelberg, Heidelberg, Germany; Institute of Clinical Epidemiology and Biometry (K.H., P.U.H.), University of Würzburg, Würzburg, Germany; Department of Neurology, University Hospital Münster, Münster, Germany (R.D.); Department of Neurology (C.K.), and Comprehensive Heart Failure Center and Clinical Trial Center (P.U.H.), University Hospital Würzburg, Würzburg, Germany; Department of Neurology, University Hospital Kiel, Kiel, Germany (A.B.); Department of Neurology, University Hospital Mainz, Mainz, Germany (K.G.); Department of Neurology, University Hospital Mannheim, Mannheim, Germany (M.G.H.); Departments of Neuroradiology (K.L.) and Stroke Medicine (R.V.), Imperial College London, London, United Kingdom; Department of Neurology, University Hospital Tübingen, Tübingen, Germany (S.P.); Department of Neurology, Asklepios Klinik Nord, Hamburg, Germany (G.S.); and Department of Neurology, Klinikum Fulda, Fulda, Germany (T.N.-H.).
authors.forename: Rainer
authors.initials: R
authors.lastname: Dziewas
authors.affiliation: From the Departments of Neurology (J.C.P., T.R., S.K., P.A.R., R.V.) and Neuroradiology (M.W.), University Hospital Heidelberg, Heidelberg, Germany; Institute of Clinical Epidemiology and Biometry (K.H., P.U.H.), University of Würzburg, Würzburg, Germany; Department of Neurology, University Hospital Münster, Münster, Germany (R.D.); Department of Neurology (C.K.), and Comprehensive Heart Failure Center and Clinical Trial Center (P.U.H.), University Hospital Würzburg, Würzburg, Germany; Department of Neurology, University Hospital Kiel, Kiel, Germany (A.B.); Department of Neurology, University Hospital Mainz, Mainz, Germany (K.G.); Department of Neurology, University Hospital Mannheim, Mannheim, Germany (M.G.H.); Departments of Neuroradiology (K.L.) and Stroke Medicine (R.V.), Imperial College London, London, United Kingdom; Department of Neurology, University Hospital Tübingen, Tübingen, Germany (S.P.); Department of Neurology, Asklepios Klinik Nord, Hamburg, Germany (G.S.); and Department of Neurology, Klinikum Fulda, Fulda, Germany (T.N.-H.).
authors.forename: Christoph
authors.initials: C
authors.lastname: Kleinschnitz
authors.affiliation: From the Departments of Neurology (J.C.P., T.R., S.K., P.A.R., R.V.) and Neuroradiology (M.W.), University Hospital Heidelberg, Heidelberg, Germany; Institute of Clinical Epidemiology and Biometry (K.H., P.U.H.), University of Würzburg, Würzburg, Germany; Department of Neurology, University Hospital Münster, Münster, Germany (R.D.); Department of Neurology (C.K.), and Comprehensive Heart Failure Center and Clinical Trial Center (P.U.H.), University Hospital Würzburg, Würzburg, Germany; Department of Neurology, University Hospital Kiel, Kiel, Germany (A.B.); Department of Neurology, University Hospital Mainz, Mainz, Germany (K.G.); Department of Neurology, University Hospital Mannheim, Mannheim, Germany (M.G.H.); Departments of Neuroradiology (K.L.) and Stroke Medicine (R.V.), Imperial College London, London, United Kingdom; Department of Neurology, University Hospital Tübingen, Tübingen, Germany (S.P.); Department of Neurology, Asklepios Klinik Nord, Hamburg, Germany (G.S.); and Department of Neurology, Klinikum Fulda, Fulda, Germany (T.N.-H.).
authors.forename: Andreas
authors.initials: A
authors.lastname: Binder
authors.affiliation: From the Departments of Neurology (J.C.P., T.R., S.K., P.A.R., R.V.) and Neuroradiology (M.W.), University Hospital Heidelberg, Heidelberg, Germany; Institute of Clinical Epidemiology and Biometry (K.H., P.U.H.), University of Würzburg, Würzburg, Germany; Department of Neurology, University Hospital Münster, Münster, Germany (R.D.); Department of Neurology (C.K.), and Comprehensive Heart Failure Center and Clinical Trial Center (P.U.H.), University Hospital Würzburg, Würzburg, Germany; Department of Neurology, University Hospital Kiel, Kiel, Germany (A.B.); Department of Neurology, University Hospital Mainz, Mainz, Germany (K.G.); Department of Neurology, University Hospital Mannheim, Mannheim, Germany (M.G.H.); Departments of Neuroradiology (K.L.) and Stroke Medicine (R.V.), Imperial College London, London, United Kingdom; Department of Neurology, University Hospital Tübingen, Tübingen, Germany (S.P.); Department of Neurology, Asklepios Klinik Nord, Hamburg, Germany (G.S.); and Department of Neurology, Klinikum Fulda, Fulda, Germany (T.N.-H.).
authors.forename: Klaus
authors.initials: K
authors.lastname: Gröschel
authors.affiliation: From the Departments of Neurology (J.C.P., T.R., S.K., P.A.R., R.V.) and Neuroradiology (M.W.), University Hospital Heidelberg, Heidelberg, Germany; Institute of Clinical Epidemiology and Biometry (K.H., P.U.H.), University of Würzburg, Würzburg, Germany; Department of Neurology, University Hospital Münster, Münster, Germany (R.D.); Department of Neurology (C.K.), and Comprehensive Heart Failure Center and Clinical Trial Center (P.U.H.), University Hospital Würzburg, Würzburg, Germany; Department of Neurology, University Hospital Kiel, Kiel, Germany (A.B.); Department of Neurology, University Hospital Mainz, Mainz, Germany (K.G.); Department of Neurology, University Hospital Mannheim, Mannheim, Germany (M.G.H.); Departments of Neuroradiology (K.L.) and Stroke Medicine (R.V.), Imperial College London, London, United Kingdom; Department of Neurology, University Hospital Tübingen, Tübingen, Germany (S.P.); Department of Neurology, Asklepios Klinik Nord, Hamburg, Germany (G.S.); and Department of Neurology, Klinikum Fulda, Fulda, Germany (T.N.-H.).
authors.forename: Michael G
authors.initials: MG
authors.lastname: Hennerici
authors.affiliation: From the Departments of Neurology (J.C.P., T.R., S.K., P.A.R., R.V.) and Neuroradiology (M.W.), University Hospital Heidelberg, Heidelberg, Germany; Institute of Clinical Epidemiology and Biometry (K.H., P.U.H.), University of Würzburg, Würzburg, Germany; Department of Neurology, University Hospital Münster, Münster, Germany (R.D.); Department of Neurology (C.K.), and Comprehensive Heart Failure Center and Clinical Trial Center (P.U.H.), University Hospital Würzburg, Würzburg, Germany; Department of Neurology, University Hospital Kiel, Kiel, Germany (A.B.); Department of Neurology, University Hospital Mainz, Mainz, Germany (K.G.); Department of Neurology, University Hospital Mannheim, Mannheim, Germany (M.G.H.); Departments of Neuroradiology (K.L.) and Stroke Medicine (R.V.), Imperial College London, London, United Kingdom; Department of Neurology, University Hospital Tübingen, Tübingen, Germany (S.P.); Department of Neurology, Asklepios Klinik Nord, Hamburg, Germany (G.S.); and Department of Neurology, Klinikum Fulda, Fulda, Germany (T.N.-H.).
authors.forename: Kyriakos
authors.initials: K
authors.lastname: Lobotesis
authors.affiliation: From the Departments of Neurology (J.C.P., T.R., S.K., P.A.R., R.V.) and Neuroradiology (M.W.), University Hospital Heidelberg, Heidelberg, Germany; Institute of Clinical Epidemiology and Biometry (K.H., P.U.H.), University of Würzburg, Würzburg, Germany; Department of Neurology, University Hospital Münster, Münster, Germany (R.D.); Department of Neurology (C.K.), and Comprehensive Heart Failure Center and Clinical Trial Center (P.U.H.), University Hospital Würzburg, Würzburg, Germany; Department of Neurology, University Hospital Kiel, Kiel, Germany (A.B.); Department of Neurology, University Hospital Mainz, Mainz, Germany (K.G.); Department of Neurology, University Hospital Mannheim, Mannheim, Germany (M.G.H.); Departments of Neuroradiology (K.L.) and Stroke Medicine (R.V.), Imperial College London, London, United Kingdom; Department of Neurology, University Hospital Tübingen, Tübingen, Germany (S.P.); Department of Neurology, Asklepios Klinik Nord, Hamburg, Germany (G.S.); and Department of Neurology, Klinikum Fulda, Fulda, Germany (T.N.-H.).
authors.forename: Sven
authors.initials: S
authors.lastname: Poli
authors.affiliation: From the Departments of Neurology (J.C.P., T.R., S.K., P.A.R., R.V.) and Neuroradiology (M.W.), University Hospital Heidelberg, Heidelberg, Germany; Institute of Clinical Epidemiology and Biometry (K.H., P.U.H.), University of Würzburg, Würzburg, Germany; Department of Neurology, University Hospital Münster, Münster, Germany (R.D.); Department of Neurology (C.K.), and Comprehensive Heart Failure Center and Clinical Trial Center (P.U.H.), University Hospital Würzburg, Würzburg, Germany; Department of Neurology, University Hospital Kiel, Kiel, Germany (A.B.); Department of Neurology, University Hospital Mainz, Mainz, Germany (K.G.); Department of Neurology, University Hospital Mannheim, Mannheim, Germany (M.G.H.); Departments of Neuroradiology (K.L.) and Stroke Medicine (R.V.), Imperial College London, London, United Kingdom; Department of Neurology, University Hospital Tübingen, Tübingen, Germany (S.P.); Department of Neurology, Asklepios Klinik Nord, Hamburg, Germany (G.S.); and Department of Neurology, Klinikum Fulda, Fulda, Germany (T.N.-H.).
authors.forename: Günter
authors.initials: G
authors.lastname: Seidel
authors.affiliation: From the Departments of Neurology (J.C.P., T.R., S.K., P.A.R., R.V.) and Neuroradiology (M.W.), University Hospital Heidelberg, Heidelberg, Germany; Institute of Clinical Epidemiology and Biometry (K.H., P.U.H.), University of Würzburg, Würzburg, Germany; Department of Neurology, University Hospital Münster, Münster, Germany (R.D.); Department of Neurology (C.K.), and Comprehensive Heart Failure Center and Clinical Trial Center (P.U.H.), University Hospital Würzburg, Würzburg, Germany; Department of Neurology, University Hospital Kiel, Kiel, Germany (A.B.); Department of Neurology, University Hospital Mainz, Mainz, Germany (K.G.); Department of Neurology, University Hospital Mannheim, Mannheim, Germany (M.G.H.); Departments of Neuroradiology (K.L.) and Stroke Medicine (R.V.), Imperial College London, London, United Kingdom; Department of Neurology, University Hospital Tübingen, Tübingen, Germany (S.P.); Department of Neurology, Asklepios Klinik Nord, Hamburg, Germany (G.S.); and Department of Neurology, Klinikum Fulda, Fulda, Germany (T.N.-H.).
authors.forename: Tobias
authors.initials: T
authors.lastname: Neumann-Haefelin
authors.affiliation: From the Departments of Neurology (J.C.P., T.R., S.K., P.A.R., R.V.) and Neuroradiology (M.W.), University Hospital Heidelberg, Heidelberg, Germany; Institute of Clinical Epidemiology and Biometry (K.H., P.U.H.), University of Würzburg, Würzburg, Germany; Department of Neurology, University Hospital Münster, Münster, Germany (R.D.); Department of Neurology (C.K.), and Comprehensive Heart Failure Center and Clinical Trial Center (P.U.H.), University Hospital Würzburg, Würzburg, Germany; Department of Neurology, University Hospital Kiel, Kiel, Germany (A.B.); Department of Neurology, University Hospital Mainz, Mainz, Germany (K.G.); Department of Neurology, University Hospital Mannheim, Mannheim, Germany (M.G.H.); Departments of Neuroradiology (K.L.) and Stroke Medicine (R.V.), Imperial College London, London, United Kingdom; Department of Neurology, University Hospital Tübingen, Tübingen, Germany (S.P.); Department of Neurology, Asklepios Klinik Nord, Hamburg, Germany (G.S.); and Department of Neurology, Klinikum Fulda, Fulda, Germany (T.N.-H.).
authors.forename: Peter A
authors.initials: PA
authors.lastname: Ringleb
authors.affiliation: From the Departments of Neurology (J.C.P., T.R., S.K., P.A.R., R.V.) and Neuroradiology (M.W.), University Hospital Heidelberg, Heidelberg, Germany; Institute of Clinical Epidemiology and Biometry (K.H., P.U.H.), University of Würzburg, Würzburg, Germany; Department of Neurology, University Hospital Münster, Münster, Germany (R.D.); Department of Neurology (C.K.), and Comprehensive Heart Failure Center and Clinical Trial Center (P.U.H.), University Hospital Würzburg, Würzburg, Germany; Department of Neurology, University Hospital Kiel, Kiel, Germany (A.B.); Department of Neurology, University Hospital Mainz, Mainz, Germany (K.G.); Department of Neurology, University Hospital Mannheim, Mannheim, Germany (M.G.H.); Departments of Neuroradiology (K.L.) and Stroke Medicine (R.V.), Imperial College London, London, United Kingdom; Department of Neurology, University Hospital Tübingen, Tübingen, Germany (S.P.); Department of Neurology, Asklepios Klinik Nord, Hamburg, Germany (G.S.); and Department of Neurology, Klinikum Fulda, Fulda, Germany (T.N.-H.).
authors.forename: Peter U
authors.initials: PU
authors.lastname: Heuschmann
authors.affiliation: From the Departments of Neurology (J.C.P., T.R., S.K., P.A.R., R.V.) and Neuroradiology (M.W.), University Hospital Heidelberg, Heidelberg, Germany; Institute of Clinical Epidemiology and Biometry (K.H., P.U.H.), University of Würzburg, Würzburg, Germany; Department of Neurology, University Hospital Münster, Münster, Germany (R.D.); Department of Neurology (C.K.), and Comprehensive Heart Failure Center and Clinical Trial Center (P.U.H.), University Hospital Würzburg, Würzburg, Germany; Department of Neurology, University Hospital Kiel, Kiel, Germany (A.B.); Department of Neurology, University Hospital Mainz, Mainz, Germany (K.G.); Department of Neurology, University Hospital Mannheim, Mannheim, Germany (M.G.H.); Departments of Neuroradiology (K.L.) and Stroke Medicine (R.V.), Imperial College London, London, United Kingdom; Department of Neurology, University Hospital Tübingen, Tübingen, Germany (S.P.); Department of Neurology, Asklepios Klinik Nord, Hamburg, Germany (G.S.); and Department of Neurology, Klinikum Fulda, Fulda, Germany (T.N.-H.). r.veltkamp@imperial.ac.uk.
authors.forename: Roland
authors.initials: R
authors.lastname: Veltkamp
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use*; D002545:Brain Ischemia / Q000188:drug therapy / Q000628:therapy*; D057510:Endovascular Procedures / Q000009:adverse effects* / Q000379:methods; D005260:Female; D006801:Humans; D020300:Intracranial Hemorrhages / Q000209:etiology*; D008297:Male; D011446:Prospective Studies; D020521:Stroke / Q000188:drug therapy / Q000628:therapy*; D017131:Thrombectomy / Q000009:adverse effects* / Q000379:methods; D015912:Thrombolytic Therapy; D016896:Treatment Outcome
chemical_list: D000925:Anticoagulants
keywords: anticoagulants; intracranial hemorrhage; stroke; thrombectomy