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Endovascular management of acute large vessel occlusion stroke in pregnancy is safe and feasible.

Publication ,  Journal Article
Limaye, K; Van de Walle Jones, A; Shaban, A; Desai, S; Al Kasab, S; Almallouhi, E; Holmstedt, CA; Ortega-Gutierrez, S; Haussen, DC; Nogueira, R ...
Published in: J Neurointerv Surg
June 2020

INTRODUCTION: Stroke is a leading cause of adult death and disability. Although acute ischemic stroke (AIS) in pregnancy is rare, it has devastating consequences on the life of the mother and fetus. Pregnancy was an exclusion criterion in endovascular thrombectomy (EVT) trials and so there are no evidence-based treatment recommendations in this subgroup. The objective of this study was to evaluate the safety and feasibility of mechanical thrombectomy in large vessel occlusion (LVO) stroke in pregnancy. METHODS: Patients with AIS due to LVO treated with EVT during pregnancy between 2000 and 2019 were identified at seven tertiary care centers. After IRB approval, retrospective analysis of prospectively maintained stroke/endovascular databases was performed. RESULTS: A total of seven subjects were identified. The average age was 33.2 years (range 25-38 years) and the average initial National Institutes of Health Stroke Scale (NIHSS) score at presentation was 15 (range 9-28). Three patients received IV tissue plasminogen activator. Techniques of EVT included stent retriever thrombectomy, stent retriever-assisted continuous aspiration, direct contact aspiration, and multimodal techniques including a rescue balloon mounted coronary stent placement. While one patient was noted to have petechial hemorrhage, no individuals developed parenchymal hematoma. Mean discharge NIHSS score was 1.7 (range 0-5). CONCLUSION: EVT is a safe and effective treatment for acute stroke secondary to LVO in this series of pregnant patients. While EVT for acute stroke is standard of care in select patient populations, our study suggests that treatment should be considered in the gravid population.

Duke Scholars

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Published In

J Neurointerv Surg

DOI

EISSN

1759-8486

Publication Date

June 2020

Volume

12

Issue

6

Start / End Page

552 / 556

Location

England

Related Subject Headings

  • Treatment Outcome
  • Stroke
  • Retrospective Studies
  • Prospective Studies
  • Pregnancy Complications
  • Pregnancy
  • Patient Discharge
  • Humans
  • Female
  • Feasibility Studies
 

Citation

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Limaye, K., Van de Walle Jones, A., Shaban, A., Desai, S., Al Kasab, S., Almallouhi, E., … Jadhav, A. (2020). Endovascular management of acute large vessel occlusion stroke in pregnancy is safe and feasible. J Neurointerv Surg, 12(6), 552–556. https://doi.org/10.1136/neurintsurg-2019-015578
Limaye, Kaustubh, Ann Van de Walle Jones, Amir Shaban, Shashvat Desai, Sami Al Kasab, Eyad Almallouhi, Christine A. Holmstedt, et al. “Endovascular management of acute large vessel occlusion stroke in pregnancy is safe and feasible.J Neurointerv Surg 12, no. 6 (June 2020): 552–56. https://doi.org/10.1136/neurintsurg-2019-015578.
Limaye K, Van de Walle Jones A, Shaban A, Desai S, Al Kasab S, Almallouhi E, et al. Endovascular management of acute large vessel occlusion stroke in pregnancy is safe and feasible. J Neurointerv Surg. 2020 Jun;12(6):552–6.
Limaye, Kaustubh, et al. “Endovascular management of acute large vessel occlusion stroke in pregnancy is safe and feasible.J Neurointerv Surg, vol. 12, no. 6, June 2020, pp. 552–56. Pubmed, doi:10.1136/neurintsurg-2019-015578.
Limaye K, Van de Walle Jones A, Shaban A, Desai S, Al Kasab S, Almallouhi E, Holmstedt CA, Ortega-Gutierrez S, Haussen DC, Nogueira R, Mont’Alverne F, Ragiotto C, Rebello LC, Jovin TG, Hasan D, Jadhav A. Endovascular management of acute large vessel occlusion stroke in pregnancy is safe and feasible. J Neurointerv Surg. 2020 Jun;12(6):552–556.

Published In

J Neurointerv Surg

DOI

EISSN

1759-8486

Publication Date

June 2020

Volume

12

Issue

6

Start / End Page

552 / 556

Location

England

Related Subject Headings

  • Treatment Outcome
  • Stroke
  • Retrospective Studies
  • Prospective Studies
  • Pregnancy Complications
  • Pregnancy
  • Patient Discharge
  • Humans
  • Female
  • Feasibility Studies