{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T03:28:18Z","timestamp":1775705298625,"version":"3.50.1"},"reference-count":22,"publisher":"Springer Science and Business Media LLC","issue":"12","license":[{"start":{"date-parts":[[2023,8,18]],"date-time":"2023-08-18T00:00:00Z","timestamp":1692316800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,8,18]],"date-time":"2023-08-18T00:00:00Z","timestamp":1692316800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Graham Dixon"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Neurol"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Mechanical thrombectomy (MT) remains an effective treatment for patients with acute ischemic stroke receiving oral anticoagulation (OAC) and large vessel occlusion (LVO). However, to date, it remains unclear whether MT is safe in patients on treatment with OAC.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Aims<\/jats:title>\n                <jats:p>In our study, we performed a propensity-matched analysis to investigate the safety and efficacy of MT in patients with acute ischemic stroke receiving anticoagulants. A propensity score method was used to target the causal inference of the observational study design.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>This observational, prospective, single-centre study included consecutive patients with acute LVO ischemic stroke of the anterior circulation. Demographic, neuro-imaging and clinical data were collected and compared according to the anticoagulation status at baseline, patients on OAC vs those not on OAC. The primary study outcomes were the occurrence of any intracerebral haemorrhage (ICH) and symptomatic ICH. The secondary study outcomes were functional independence at 90\u00a0days after stroke (defined as modified Rankin Scale (mRS) scores of 0 through 2), mortality at 3\u00a0months and successful reperfusion rate according to the modified treatment in cerebral infarction (mTICI) score.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Overall, our cohort included 573 patients with acute ischemic stroke and LVO treated with MT. After propensity score matching, 495 patients were matched (99 OAC group vs 396 no OAC group). There were no differences in terms of clinical characteristics between the two groups, except for the rate of intravenous thrombolysis less frequently given in the OAC group. There was no significant difference in terms of the rate of any ICH and symptomatic ICH between the two groups. With regards to the secondary study outcome, there was no significant difference in terms of the rate of successful recanalization post-procedure and functional independence at 3\u00a0months between the two groups. Patients in the OAC group showed a reduced mortality rate at 90\u00a0days compared to the patients with no previous use of anticoagulation (20.2% vs 21.2%, <jats:italic>p<\/jats:italic>\u2009=\u20090.031). Logistic regression analysis did not reveal a statistically significant influence of the anticoagulation status on the likelihood of any ICH (OR\u2009=\u20090.95, 95% CI\u2009=\u20090.46\u20131.97, <jats:italic>p<\/jats:italic>\u2009=\u20090.900) and symptomatic ICH (OR\u2009=\u20094.87, 95% CI\u2009=\u20090.64\u201337.1, <jats:italic>p<\/jats:italic>\u2009=\u20090.127). Our analysis showed also that pre-admission anticoagulant use was not associated with functional independence at 90\u00a0days after stroke (OR\u2009=\u20090.76, 95% CI\u2009=\u20090.39\u20131.48, <jats:italic>p<\/jats:italic>\u2009=\u20090.422) and rate of successful reperfusion (OR\u2009=\u20090.81, 95% CI\u2009=\u20090.38\u20131.72, <jats:italic>p<\/jats:italic>\u2009=\u20090.582).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>According to our findings anticoagulation status at baseline did not raise any suggestion of safety and efficacy concerns when MT treatment is provided according to the standard guidelines. Confirmation of these results in larger controlled prospective cohorts is necessary.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00415-023-11926-5","type":"journal-article","created":{"date-parts":[[2023,8,18]],"date-time":"2023-08-18T18:02:12Z","timestamp":1692381732000},"page":"5827-5834","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Outcomes of mechanical thrombectomy in orally anticoagulated patients with anterior circulation large vessel occlusion: a propensity-matched analysis of the Imperial College Thrombectomy Registry"],"prefix":"10.1007","volume":"270","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6794-3850","authenticated-orcid":false,"given":"Lucio","family":"D\u2019Anna","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michele","family":"Romoli","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matteo","family":"Foschi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samir","family":"Abu-Rumeileh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tsering","family":"Dolkar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Orsolya","family":"Vittay","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luke","family":"Dixon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Bentley","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zoe","family":"Brown","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles","family":"Hall","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sohaa","family":"Jamil","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harri","family":"Jenkins","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph","family":"Kwan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberta","family":"La Cava","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maneesh","family":"Patel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neil","family":"Rane","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dylan","family":"Roi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abhinav","family":"Singh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marius","family":"Venter","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Omid","family":"Halse","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abid","family":"Malik","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dheeraj","family":"Kalladka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Soma","family":"Banerjee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kyriakos","family":"Lobotesis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2023,8,18]]},"reference":[{"key":"11926_CR1","first-page":"E364","volume":"2021","author":"DO Kleindorfer","year":"2021","unstructured":"Kleindorfer DO, Towfighi A, Chaturvedi S et al (2021) Guideline for the prevention of stroke in patients with stroke and transient ischemic attack; a guideline from the American Heart Association\/American Stroke Association. Stroke 2021:E364\u2013E467","journal-title":"Stroke"},{"key":"11926_CR2","doi-asserted-by":"publisher","first-page":"215","DOI":"10.1177\/1538574417698905","volume":"51","author":"S Vidale","year":"2017","unstructured":"Vidale S, Agostoni E (2017) Endovascular treatment of ischemic stroke: an updated meta-analysis of efficacy and safety. Vasc Endovascular Surg 51:215\u2013219","journal-title":"Vasc Endovascular Surg"},{"key":"11926_CR3","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2020.594251","author":"ME Ramos-Araque","year":"2020","unstructured":"Ramos-Araque ME, Chavarr\u00eda-Miranda A, G\u00f3mez-Vicente B et al (2020) Oral anticoagulation and risk of symptomatic hemorrhagic transformation in stroke patients treated with mechanical thrombectomy: data from the nordictus registry. Front Neurol. https:\/\/doi.org\/10.3389\/fneur.2020.594251. (Epub ahead of print 26 November 2020)","journal-title":"Front Neurol"},{"key":"11926_CR4","doi-asserted-by":"publisher","DOI":"10.1186\/s12959-022-00394-y","author":"JH Chen","year":"2022","unstructured":"Chen JH, Hong CT, Chung CC et al (2022) Safety and efficacy of endovascular thrombectomy in acute ischemic stroke treated with anticoagulants: a systematic review and meta-analysis. Thromb J. https:\/\/doi.org\/10.1186\/s12959-022-00394-y. (Epub ahead of print 1 December 2022)","journal-title":"Thromb J"},{"key":"11926_CR5","doi-asserted-by":"publisher","first-page":"834","DOI":"10.1136\/neurintsurg-2017-013504","volume":"10","author":"G Zapata-Wainberg","year":"2018","unstructured":"Zapata-Wainberg G, Xim\u00e9nez-Carrillo \u00c1, Trillo S et al (2018) Mechanical thrombectomy in orally anticoagulated patients with acute ischemic stroke. J Neurointerv Surg 10:834\u2013838","journal-title":"J Neurointerv Surg"},{"key":"11926_CR6","doi-asserted-by":"publisher","first-page":"207","DOI":"10.1016\/j.jns.2017.06.004","volume":"379","author":"K Suzuki","year":"2017","unstructured":"Suzuki K, Aoki J, Sakamoto Y et al (2017) Low risk of ICH after reperfusion therapy in acute stroke patients treated with direct oral anti-coagulant. J Neurol Sci 379:207\u2013211","journal-title":"J Neurol Sci"},{"key":"11926_CR7","doi-asserted-by":"publisher","first-page":"E29","DOI":"10.1136\/neurintsurg-2017-013714","volume":"10","author":"V L\u2019allinec","year":"2018","unstructured":"L\u2019allinec V, Ernst M, Sevin-Allouet M et al (2018) Safety and efficacy of mechanical thrombectomy in acute ischemic stroke of anticoagulated patients. J Neurointerv Surg 10:E29","journal-title":"J Neurointerv Surg"},{"key":"11926_CR8","doi-asserted-by":"publisher","first-page":"1261","DOI":"10.1161\/CIRCULATIONAHA.115.015484","volume":"132","author":"DJ Seiffge","year":"2015","unstructured":"Seiffge DJ, Hooff RJ, Nolte CH et al (2015) Recanalization therapies in Acute ischemic stroke patients impact of prior treatment with novel oral anticoagulants on bleeding complications and outcome a pilot study. Circulation 132:1261\u20131269","journal-title":"Circulation"},{"key":"11926_CR9","doi-asserted-by":"publisher","first-page":"534","DOI":"10.1136\/jnnp-2020-325456","volume":"92","author":"DJ Seiffge","year":"2021","unstructured":"Seiffge DJ, Meinel T, Purrucker JC et al (2021) Recanalisation therapies for acute ischaemic stroke in patients on direct oral anticoagulants. J Neurol Neurosurg Psychiatry 92:534\u2013541","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"11926_CR10","doi-asserted-by":"publisher","first-page":"1127","DOI":"10.1161\/STROKEAHA.116.012684","volume":"47","author":"JC Purrucker","year":"2016","unstructured":"Purrucker JC, Wolf M, Haas K et al (2016) Safety of endovascular thrombectomy in patients receiving non-Vitamin K antagonist oral anticoagulants. Stroke 47:1127\u20131130","journal-title":"Stroke"},{"key":"11926_CR11","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2021.117545","author":"J Koge","year":"2021","unstructured":"Koge J, Tanaka K, Yamagami H et al (2021) Mechanical thrombectomy for stroke patients anticoagulated with direct oral anticoagulants versus warfarin. J Neurol Sci. https:\/\/doi.org\/10.1016\/j.jns.2021.117545. (Epub ahead of print 15 August 2021)","journal-title":"J Neurol Sci"},{"key":"11926_CR12","doi-asserted-by":"publisher","first-page":"350","DOI":"10.1007\/s11239-022-02680-y","volume":"54","author":"P Krieger","year":"2022","unstructured":"Krieger P, Melmed KR, Torres J et al (2022) Pre-admission antithrombotic use is associated with 3-month mRS score after thrombectomy for acute ischemic stroke. J Thromb Thrombolysis 54:350\u2013359","journal-title":"J Thromb Thrombolysis"},{"key":"11926_CR13","doi-asserted-by":"publisher","first-page":"706","DOI":"10.1007\/s00270-018-1902-7","volume":"41","author":"D \u010cern\u00edk","year":"2018","unstructured":"\u010cern\u00edk D, \u0160a\u0148\u00e1k D, Divi\u0161ov\u00e1 P et al (2018) Mechanical thrombectomy in patients with acute ischemic stroke on anticoagulation therapy. Cardiovasc Intervent Radiol 41:706\u2013711","journal-title":"Cardiovasc Intervent Radiol"},{"key":"11926_CR14","doi-asserted-by":"publisher","DOI":"10.1161\/SVIN.122.000690","author":"L D\u2019Anna","year":"2023","unstructured":"D\u2019Anna L, Dolkar T, Vittay O et al (2023) Comparison of drip-and-ship versus mothership delivery models of mechanical thrombectomy delivery. Stroke. https:\/\/doi.org\/10.1161\/SVIN.122.000690. (Epub ahead of print 20 December 2022)","journal-title":"Stroke"},{"key":"11926_CR15","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12031150","author":"L D\u2019Anna","year":"2023","unstructured":"D\u2019Anna L, Foschi M, Russo M et al (2023) Endovascular thrombectomy with or without intravenous thrombolysis for anterior circulation large vessel occlusion in the imperial college london thrombectomy registry. J Clin Med. https:\/\/doi.org\/10.3390\/jcm12031150. (Epub ahead of print 1 February 2023)","journal-title":"J Clin Med"},{"key":"11926_CR16","first-page":"1534","volume":"22","author":"JHW Pexman","year":"2001","unstructured":"Pexman JHW, Barber PA, Hill MD et al (2001) Use of the Alberta Stroke Program Early CT Score (ASPECTS) for assessing CT scans in patients with acute stroke. Am J Neuroradiol 22:1534\u20131542","journal-title":"Am J Neuroradiol"},{"key":"11926_CR17","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1056\/NEJMoa1706442","volume":"378","author":"RG Nogueira","year":"2018","unstructured":"Nogueira RG, Jadhav AP, Haussen DC et al (2018) Thrombectomy 6 to 24 hours after stroke with a mismatch between deficit and infarct. N Engl J Med 378:11\u201321","journal-title":"N Engl J Med"},{"key":"11926_CR18","doi-asserted-by":"publisher","first-page":"708","DOI":"10.1056\/NEJMoa1713973","volume":"378","author":"GW Albers","year":"2018","unstructured":"Albers GW, Marks MP, Kemp S et al (2018) Thrombectomy for stroke at 6 to 16 hours with selection by perfusion imaging. N Engl J Med 378:708\u2013718","journal-title":"N Engl J Med"},{"issue":"3","key":"11926_CR19","doi-asserted-by":"publisher","first-page":"892","DOI":"10.1161\/STROKEAHA.119.026606","volume":"51","author":"TR Meinel","year":"2020","unstructured":"Meinel TR, Kniepert JU, Seiffge DJ et al (2020) Endovascular stroke treatment and risk of intracranial hemorrhage in anticoagulated patients. Stroke 51(3):892\u2013898","journal-title":"Stroke"},{"key":"11926_CR20","doi-asserted-by":"publisher","first-page":"1138","DOI":"10.1016\/S1474-4422(16)30177-6","volume":"15","author":"S Bracard","year":"2016","unstructured":"Bracard S, Ducrocq X, Mas JL et al (2016) Mechanical thrombectomy after intravenous alteplase versus alteplase alone after stroke (THRACE): a randomised controlled trial. Lancet Neurol 15:1138\u20131147","journal-title":"Lancet Neurol"},{"key":"11926_CR21","doi-asserted-by":"publisher","first-page":"2285","DOI":"10.1056\/NEJMoa1415061","volume":"372","author":"JL Saver","year":"2015","unstructured":"Saver JL, Goyal M, Bonafe A et al (2015) Stent-retriever thrombectomy after intravenous t-PA vs. t-PA alone in stroke. New England J Med 372:2285\u20132295","journal-title":"New England J Med"},{"key":"11926_CR22","doi-asserted-by":"publisher","first-page":"1762","DOI":"10.1007\/s00415-020-10369-6","volume":"268","author":"C K\u00fcpper","year":"2021","unstructured":"K\u00fcpper C, Feil K, Wollenweber FA et al (2021) Endovascular stroke treatment in orally anticoagulated patients: an analysis from the German Stroke Registry-Endovascular Treatment. J Neurol 268:1762\u20131769","journal-title":"J Neurol"}],"container-title":["Journal of Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00415-023-11926-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00415-023-11926-5\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00415-023-11926-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,8]],"date-time":"2023-11-08T14:07:15Z","timestamp":1699452435000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00415-023-11926-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,18]]},"references-count":22,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2023,12]]}},"alternative-id":["11926"],"URL":"https:\/\/doi.org\/10.1007\/s00415-023-11926-5","relation":{},"ISSN":["0340-5354","1432-1459"],"issn-type":[{"value":"0340-5354","type":"print"},{"value":"1432-1459","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8,18]]},"assertion":[{"value":"12 May 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 July 2023","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 August 2023","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 August 2023","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"All authors declare that there is no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of interest"}},{"value":"The study was conducted in accordance with the recommendations for physicians involved in research on human subjects adopted by the 18th World Medical Assembly, Helsinki 1964 and later revisions.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical standard"}}]}}