The aim of the study was to analyze short –term outcome as measured by mRS on discharge in acute ischemic stroke (AIS) patients on therapeutic anticoagulation treated by mechanical thrombectomy (MT).

Ten percent of patients with AIS are on therapeutic anticoagulation. There are limited data on outcome for these patients treated by MT.

The study was conducted on patients treated at the Comprehensive Stroke Center in Krakow, Poland, serving  for 3,5 million of inhabitants. The following data were collected in each patient: demographics, stroke risk factors, stroke etiology according to TOAST, NIHSS  on admission, clot location,  hemorrhagic transformation according to ECASS-2 criteria on CT taken 24 hours after stroke, effect of recanalization as measured  by  the TICI score (poor recanalization  was defined as TICI 0-2a) and time lapse between stroke onset and groin puncture.  Early outcome measure was mRS on the day of discharge (day 9). Poor outcome was defined as mRS >2.

We included 291 patients (49% women, mean age: 66±15 years) who underwent MT since 2013 year. 37 patients were  on therapeutic anticoagulation during the procedure, warfarin: 14 (37,8%); full dose heparin: 5 (13,5%); dabigatran: 5 (13,5%) or rivaroxaban: 13 (35,0%). Univariate analysis showed that anticoagulated patients as compared to others were older, had more often ischemic heart disease or atrial fibrillation (p<0.05). The did not differ in respect to clot location, TICI score after the procedure, hemorrhagic transformation on CT or mRS profile on the day of discharge. Multivariate analysis showed that older age (OR=1.05; 95CI:1,03-1,08); time lapse between stroke onset and groin puncture (OR=1,28; 95%CI:1,07-1,53); hemorrhagic transformation (OR=3,64; 95%CI:1.99-6.68); poor recanalization (OR=8,17;95%CI:3,78-17,68) or diabetes mellitus (OR=1,97;95%CI:1:00-1.967) affected poor short-term outcome; however, therapeutic anticoagulation did not  (OR=0,90;95%CI:0,39-2,21).

 MT in anticoagulated patients does not affect short-term outcome. Larger systematic studies are needed to confirm our findings.