Heparin during endovascular stroke treatment seems safe

Background and purpose. - the effect of intravenous heparin during mechanical thrombectomy for acute ischemic stroke is not clear. We aimed to study efficacy and safety of heparin use during endovascular stroke treatment in a real-world setting.Materials and methods. - patients with anterior circulation stroke were divided, based on the use of intraprocedural heparin, in those treated and those untreated. Main outcomes were successful reperfusion defined as a TICI Score >= 2b, 3-month functional independence defined as a modified Rankin Scale <= 2, symptomatic intracranial hemorrhage (sICH) and mortality.Results. - 361 patients were eligible for analysis; 200 were (H+) and 161 (H-). The (H-) group showed higher age and ASPECTS (74 +/- 14 vs. 68.9 +/- 12.2; P = 0.001; 8 +/- 1.6 vs. 7.4 +/- 2.1; P = 0.009) without differences in vascular risk factors. Heparin untreated patients showed a shorter onset-to-reperfusion time (271 +/- 57.6 min vs. 309 +/- 102.2 min; P < 0.001). No differences were found in 3-month functional independence, sICH and mortality whereas the rate of successful reperfusion was higher in the (H-) group. After logistic regression analysis successful reperfusion was independently associated with CT ASPECTS (OR: 1.16; 95%CI 1.01-1.35; P=0.040) but inversely associated with the use of heparin (OR: 0.48; 95% CI 0.24-0.98; P=0.045).Conclusions. - Heparin use during mechanical thrombectomy for anterior circulation acute ischemic stroke in a real world setting is safe. (C) 2019 Elsevier Masson SAS. All rights reserved.