Safety of Endovascular Treatment Analyzed in Acute Stroke Patients Taking Oral Anticoagulants
December 22, 2016—An analysis of the European ENDOSTROKE-Registry, which evaluated the safety of endovascular treatment in patients treated with oral anticoagulants, found that previous use of vitamin-K-antagonists was not associated with either a higher rate of periprocedural intracranial hemorrhage after endovascular treatment or a worse outcome. Investigators concluded that endovascular treatment should be considered as an important treatment option in patients taking vitamin-K-antagonists. The study was published online by Timo Uphaus, MD, et al in the International Journal of Stroke.
According to the investigators, the ENDOSTROKE-Registry is a commercially independent, prospective, observational study in 12 stroke centers in Germany and Austria collecting prespecified variables about endovascular stroke therapy.
They analyzed data from 815 patients (median age 70 years; 57% men) undergoing endovascular treatment with known anticoagulation status. A total of 85 (median age 76; 52% men) patients (10.4%) took vitamin-K-antagonists before endovascular treatment. Anticoagulation status, as measured by the international normalized ratio, was above 2.0 in 31 patients.
As summarized in the International Journal of Stroke, the investigators reported that intracranial hemorrhage occurred in 11.8% of patients taking vitamin-K-antagonists compared with 12.2% of patients who took no vitamin-K-antagonists (P = .909). After adjustment for confounding factors that were unbalanced at the univariate level, anticoagulation status was not found to significantly influence the clinical outcome (modified Rankin Scale 3–6) and occurrence of intracranial hemorrhage in a multivariate logistic regression analysis.