ESMINT-EYMINT Survey Seeks to Assess Heparin Use in Stroke Thrombectomy

December 19, 2022—The European Society of Minimally Invasive Neurological Therapy (ESMINT) and EYMINT, its organization of young interventionists, are conducting a survey to obtain an overview of the use of any heparin in endovascular thrombectomy (EVT) practices in Europe. The survey is supported by the ESMINT and EYMINT research collaborative group.

Interventionists in Europe may access the survey online.

According to the ESMINT-EYMINT introduction to the survey, heparin use during EVT for acute ischemic stroke (AIS) and its impact on functional outcome is often underestimated, which is reflected by the results of the MR CLEAN MED trial. Additionally, the use of heparin in infusion bags, which flush the catheters during the treatment, is not considered in the recent trials regarding the impact of antithrombotics during EVT (MR CLEAN MED; MR CLEAN–NO IV) and could have influenced the results.

However, the heparin dose during EVT (ie, as intravenous (IV) bolus and/or as heparin in flush fluids infusion bags) has high interindividual variability, mainly because of procedural factors (eg, whether or not an IV bolus is given, the number of infusion bags used, the timing of connecting the bag, drip rate). This variability should first be investigated to truly analyze the impact on functional outcome after EVT, stated ESMINT-EYMINT.

The survey will provide more insight in how European interventionists consider their heparin administration during EVT. Data will be treated anonymously and will be used for additional research projects regarding heparin (flush) use in EVT for AIS and its impact on outcome, advised ESMINT-EYMINT.

In March 2022, the findings from MR CLEAN-MED, an open-label, multicenter, randomized controlled trial evaluating the safety and efficacy of aspirin, unfractionated heparin, both, or neither during endovascular stroke treatment were published by Wouter van der Steen, MD et al in The Lancet (2022;399:1059-1069).

In November 2021, Natalie E. LeCouffe, MD, et al for the MR CLEAN–NO IV investigators published findings from that randomized trial of intravenous alteplase before endovascular treatment for stroke in The New England Journal of Medicine (2021;385:1833-1844).