Recanalization therapies in acute ischemic stroke patients

You'll have to ask your doctor what the hell this means. Obviously written to confuse the layperson. And our fucking failures of stroke associations won't put research out in readable form.
http://www.mdlinx.com/internal-medicine/medical-news-article/2015/09/29/anticoagulants-endovascular-procedures-intra-arterial-treatment/6345509/?

The authors explored the safety of intravenous thrombolysis (IVT) or intra–arterial treatment (IAT) in patients with ischemic stroke on non–vitamin K antagonist oral anticoagulants (NOACs, last intake <48 hours) in comparison with patients (1) taking vitamin K antagonists (VKAs) or (2) without previous anticoagulation (no–OAC). IVT/IAT in selected patients with ischemic stroke under NOAC treatment has a safety profile similar to both IVT/IAT in patients on subtherapeutic VKA treatment or in those without previous anticoagulation. However, further prospective studies are needed, including the impact of specific coagulation tests.

Methods

• This is a multicenter cohort pilot study. Primary outcome measures were (1) occurrence of intracranial hemorrhage (ICH) in 3 categories: any ICH (ICHany), symptomatic ICH according to the criteria of the European Cooperative Acute Stroke Study II (ECASS–II) (sICHECASS–II) and the National Institute of Neurological Disorders and Stroke (NINDS) thrombolysis trial (sICHNINDS); and (2) death (at 3 months).
• Cohorts were compared by using propensity score matching.
• The NOAC cohort comprised 78 patients treated with IVT/IAT and the comparison groups of 441 VKA patients and 8938 no–OAC patients.

Results

• The median time from last NOAC intake to IVT/IAT was 13 hours (interquartile range, 8–22 hours).
• In VKA patients, median pre–IVT/IAT international normalized ratio was 1.3 (interquartile range, 1.1–1.6).
• ICHany was observed in 18.4% NOAC patients versus 26.8% in VKA patients and 17.4% in no–OAC patients.
• sICHECASS–II and sICHNINDS occurred in 2.6%/3.9% NOAC patients, in comparison with 6.5%/9.3% of VKA patients and 5.0%/7.2% of no–OAC patients, respectively.
• At 3 months, 23.0% of NOAC patients in comparison with 26.9% of VKA patients and 13.9% of no–OAC patients had died. Propensity score matching revealed no statistically significant differences.

Go to PubMed Go to Abstract Print Article Summary Cat 2 CME Report