{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T20:38:45Z","timestamp":1793392725132,"version":"4.5.0"},"reference-count":85,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2017,11,24]],"date-time":"2017-11-24T00:00:00Z","timestamp":1511481600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["International Journal of Stroke"],"published-print":{"date-parts":[[2018,6]]},"abstract":"<jats:p>Endovascular mechanical thrombectomy (MT) for the treatment of acute stroke due to large vessel occlusion has evolved significantly with the publication of multiple positive thrombectomy trials. MT is now a recommended treatment for acute ischemic stroke. Mechanical thrombectomy is associated with a number of intra-procedural or post-operative complications, which need to be minimized and effectively managed to maximize the benefits of thrombectomy. Procedural complications include: access-site problems (vessel\/nerve injury, access-site hematoma and groin infection); device-related complications (vasospasm, arterial perforation and dissection, device detachment\/misplacement); symptomatic intracerebral hemorrhage; subarachnoid hemorrhage; embolization to new or target vessel territory. Other complications include: anesthetic\/contrast-related, post-operative hemorrhage, extra-cranial hemorrhage and pseudoaneurysm. Some complications are life-threatening and many lead to increased length of stay in intensive care and stroke units. Complications increase costs and delay the commencement of rehabilitation. Some may be preventable; the impact of others can be minimized with early detection and appropriate management. Both neurointerventionists and stroke specialists need to be aware of the risk factors, strategies for prevention, and management of these complications. With the increasing use of mechanical thrombectomy for the treatment of acute ischemic stroke, incidence and outcome of complications will need to be carefully monitored by stroke teams. In this narrative review, we examine the frequency of complications of MT in the treatment of acute ischemic stroke with an emphasis on periprocedural complications. Overall, from recent randomized controlled trials, the risk of complications with sequelae for patient from mechanical thrombectomy is \u223c15%. We discuss the management of complications and identify areas with limited evidence, which need further research.<\/jats:p>\n                  <jats:p>Search strategy and selection criteria<\/jats:p>\n                  <jats:p>Relevant evidence was found by searches of Medline and Cochrane Library, reference list, cross-referencing and main journal content pages. Search terms included \u201cbrain ischemia\u201d, \u201cacute ischemic stroke\u201d, \u201ccerebral infarction\u201d AND \u201cmechanical thrombectomy\u201d, \u201cendovascular therapy\u201d, \u201cendovascular treatment\u201d, \u201cendovascular embolectomy\u201d, \u201cintra-arterial\u201d AND \u201crandomized controlled trial\u201d, \u201cnon-randomised trials\u201d, \u201cobservational studies\u201d AND \u201ccomplications\u201d, \u201cprocedural complications\u201d, \u201cperi-procedural complications\u201d, \u201cdevice-related complications\u201d, \u201cmanagement\u201d, \u201ctreatment\u201d, \u201coutcome\u201d. The search included only human studies, and was limited to studies published in English between January 2014 and November 2016. The final reference list was selected on the basis of relevance to the topics covered in the Review. Guidelines for management of acute ischaemic stroke by the American Heart Association, the European Stroke Organisation, multi-disciplinary guidelines and the National Institute for Health and Care Excellence (NICE) were also reviewed.<\/jats:p>","DOI":"10.1177\/1747493017743051","type":"journal-article","created":{"date-parts":[[2017,11,24]],"date-time":"2017-11-24T07:10:26Z","timestamp":1511507426000},"page":"348-361","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":258,"title":["Complications of endovascular treatment for acute ischemic stroke: Prevention and management"],"prefix":"10.1177","volume":"13","author":[{"given":"Joyce S","family":"Balami","sequence":"first","affiliation":[{"name":"Centre for Evidence Based Medicine, University of Oxford, Oxford, UK"},{"name":"Norfolk and Norwich University Teaching Hospital NHS Trust, Norwich, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip M","family":"White","sequence":"additional","affiliation":[{"name":"Stroke Research Group, Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter J","family":"McMeekin","sequence":"additional","affiliation":[{"name":"School of Health, Community and Education Studies, Northumbria University, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary A","family":"Ford","sequence":"additional","affiliation":[{"name":"John Radcliffe Hospital, Oxford University Hospitals NHS Trust, Oxford, UK"},{"name":"Radcliffe Department of Medicine, University of Oxford, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alastair M","family":"Buchan","sequence":"additional","affiliation":[{"name":"Acute Stroke Programme, Radcliffe Department of Medicine, University of Oxford, Oxford, UK"},{"name":"Acute Vascular Imaging Centre, John Radcliffe Hospital, University of Oxford, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2017,11,24]]},"reference":[{"key":"bibr1-1747493017743051","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1411587"},{"key":"bibr2-1747493017743051","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1414905"},{"key":"bibr3-1747493017743051","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1414792"},{"key":"bibr4-1747493017743051","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1415061"},{"key":"bibr5-1747493017743051","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1503780"},{"key":"bibr6-1747493017743051","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(16)30177-6"},{"key":"bibr7-1747493017743051","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2016-314117"},{"key":"bibr8-1747493017743051","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.116.012619"},{"key":"bibr9-1747493017743051","doi-asserted-by":"publisher","DOI":"10.1111\/ene.12944"},{"key":"bibr10-1747493017743051","doi-asserted-by":"publisher","DOI":"10.1111\/ene.12958"},{"key":"bibr11-1747493017743051","doi-asserted-by":"publisher","DOI":"10.1136\/neurintsurg-2015-012236"},{"key":"bibr12-1747493017743051","doi-asserted-by":"publisher","DOI":"10.1016\/j.crad.2015.08.007"},{"key":"bibr13-1747493017743051","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.115.011050"},{"key":"bibr14-1747493017743051","unstructured":"Royal 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A, Soize S, Serre I, et\u00a0al. Technical feasibility of mechanical thrombectomy under conscious sedation and comprehensive evaluation of procedural complications: four years of experience with stent-retriever devices.\n                      EJMINT\n                      Original Article, 2014: 1436000148 (4 September 2014)."},{"key":"bibr46-1747493017743051","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A3707"},{"key":"bibr47-1747493017743051","doi-asserted-by":"publisher","DOI":"10.1111\/j.1552-6569.2008.00197.x"},{"key":"bibr48-1747493017743051","doi-asserted-by":"publisher","DOI":"10.1136\/neurintsurg-2013-010743"},{"key":"bibr49-1747493017743051","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)00163-X"},{"key":"bibr50-1747493017743051","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.115.012586"},{"key":"bibr51-1747493017743051","doi-asserted-by":"publisher","DOI":"10.1007\/s00234-013-1191-4"},{"key":"bibr52-1747493017743051","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0144452"},{"key":"bibr53-1747493017743051","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.114.008171"},{"key":"bibr54-1747493017743051","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e31826958e3"},{"key":"bibr55-1747493017743051","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A3044"},{"key":"bibr56-1747493017743051","doi-asserted-by":"publisher","DOI":"10.1161\/STR.0000000000000069"},{"key":"bibr57-1747493017743051","doi-asserted-by":"publisher","DOI":"10.1007\/s00062-014-0294-6"},{"key":"bibr58-1747493017743051","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.112.675546"},{"key":"bibr59-1747493017743051","doi-asserted-by":"publisher","DOI":"10.1177\/1971400915576650"},{"key":"bibr60-1747493017743051","doi-asserted-by":"publisher","DOI":"10.3340\/jkns.2014.56.6.463"},{"key":"bibr61-1747493017743051","doi-asserted-by":"publisher","DOI":"10.1159\/000441920"},{"key":"bibr62-1747493017743051","doi-asserted-by":"publisher","DOI":"10.1007\/s00270-014-1022-y"},{"key":"bibr63-1747493017743051","doi-asserted-by":"publisher","DOI":"10.1136\/neurintsurg-2014-011224"},{"key":"bibr64-1747493017743051","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.115.009530"},{"key":"bibr65-1747493017743051","doi-asserted-by":"publisher","DOI":"10.1136\/neurintsurg-2013-010942"},{"key":"bibr66-1747493017743051","doi-asserted-by":"crossref","first-page":"2993","DOI":"10.1161\/STROKEAHA.116.014852","volume":"47","author":"Ganesh A","year":"2016","journal-title":"Stroke"},{"key":"bibr67-1747493017743051","doi-asserted-by":"publisher","DOI":"10.1136\/neurintsurg-2014-011491"},{"key":"bibr68-1747493017743051","doi-asserted-by":"publisher","DOI":"10.1136\/neurintsurg-2015-012208"},{"key":"bibr69-1747493017743051","doi-asserted-by":"publisher","DOI":"10.1177\/1747493016647735"},{"key":"bibr70-1747493017743051","unstructured":"White PM, Bhalla A, Dinsmore J, et\u00a0al.; on behalf of British Association of Stroke Physicians, British Society of Neuroradiologists, Intercollegiate Stroke WorkingParty, Neuroanaesthesia and Neurocritical Care Society of GB & Ireland, UK Neurointerventional Group, 2015. Standards for providing safe acute ischaemic stroke thrombectomy. BASP. http:\/\/bsnr.org.uk\/wp-content\/uploads\/2014\/05\/Standards-for-providing-safe-acute-ischaemic-stroke-thrombectomy-services-Oct14.pdf."},{"key":"bibr71-1747493017743051","unstructured":"National Institute for Health and Care Excellence (NICE). Mechanical clot retrieval for treating acute ischaemic stroke. Interventional procedure, guidancenice.org.uk\/guidance\/ ipg548 (accessed 26 February 2016)."},{"key":"bibr72-1747493017743051","doi-asserted-by":"crossref","unstructured":"Lapergue B, Labreuche J and Piotin M; Aster trial. Contact aspiration vs stent retriever front line for rencanalization in acute cerebral infarction. In:\n                      2017 International Stroke Conference\n                      , Houston, TX, USA, 22\u201324 February 2017, Abstract LB2.","DOI":"10.1016\/j.neurad.2017.01.014"},{"key":"bibr73-1747493017743051","doi-asserted-by":"publisher","DOI":"10.3171\/2016.11.JNS161563"},{"key":"bibr74-1747493017743051","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A4840"},{"key":"bibr75-1747493017743051","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.113.002407"},{"key":"bibr76-1747493017743051","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2015150575"},{"key":"bibr77-1747493017743051","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-016-4338-y"},{"key":"bibr78-1747493017743051","doi-asserted-by":"publisher","DOI":"10.3171\/2017.1.FOCUS16500"},{"key":"bibr79-1747493017743051","first-page":"11","volume":"8","author":"Villwock MR","year":"2015","journal-title":"J Vasc Interv Neurol"},{"key":"bibr80-1747493017743051","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000002976"},{"key":"bibr81-1747493017743051","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.117.017786"},{"key":"bibr82-1747493017743051","author":"Treurniet KM","year":"2017","journal-title":"J Neuro Interv Surg"},{"key":"bibr83-1747493017743051","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.117.016554"},{"key":"bibr84-1747493017743051","unstructured":"Anesthetic strategy during endovascular therapy: general anesthesia or conscious sedation? (GOLIATH \u2013 General or Local Anesthesia in Intra Arterial Therapy) A single-center randomized trial. NCT01872884, https:\/\/clinicaltrials.gov (accessed 1 November 2017)."},{"key":"bibr85-1747493017743051","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.16623"}],"container-title":["International Journal of Stroke"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1747493017743051","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1747493017743051","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1747493017743051","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T07:15:42Z","timestamp":1777706142000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1747493017743051"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,11,24]]},"references-count":85,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2018,6]]}},"alternative-id":["10.1177\/1747493017743051"],"URL":"https:\/\/doi.org\/10.1177\/1747493017743051","relation":{},"ISSN":["1747-4930","1747-4949"],"issn-type":[{"value":"1747-4930","type":"print"},{"value":"1747-4949","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,11,24]]}}}