Abstract Details

Title Endovascular Thrombectomy for Treatment of Acute Ischemic Stroke During Pregnancy and the Early Postpartum Period

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P1 - Poster Session 1 (9:00 AM-5:00 PM)

Poster/Presentation
Number 082

Objective To characterize the utilization and short-outcomes of endovascular thrombectomy (EVT) for treatment of acute ischemic stroke (AIS) during pregnancy and the early postpartum period.

Background AIS is a rare occurrence during pregnancy and the postpartum period. Existing literature evaluating EVT for this patient population is limited.

Design/Methods The National Inpatient Sample was queried from 2012 to 2018 to identify and characterize pregnant and postpartum patients (up to 6 weeks following childbirth) with AIS treated with EVT. Complications and outcomes were compared with nonpregnant female patients treated with EVT and to other pregnant and postpartum patients managed medically. Complex samples regression models and propensity score matching were implemented to assess adjusted associations and to address confounding by indication, respectively.

Results Among 4590 pregnant and postpartum patients with AIS, 180 (3.9%) were treated with MT, and rates of utilization increased following the MT clinical trial era (2015–2018; 1.9% versus 5.3%, P=0.011). Compared with nonpregnant patients with AIS treated with MT, they experienced lower rates of intracranial hemorrhage (11% versus 24%, P=0.069) and poor functional outcome (50% versus 72%, P=0.003) at discharge. Pregnant/postpartum status was independently associated with a lower likelihood of development of intracranial hemorrhage (adjusted odds ratio, 0.26 [95% CI, 0.09–0.70]; P=0.008) following multivariable analysis adjusting for age, illness severity, and stroke severity. Following propensity score matching, pregnant and postpartum patients treated with MT and those medically managed differed in frequency of venous thromboembolism (17% versus 0%, P=0.001) and complications related to pregnancy (44% versus 64%, P=0.034), but not in functional outcome at discharge or hospital length of stay. Pregnant and postpartum women treated with MT did not experience mortality or miscarriage during hospitalization.

Conclusions This large-scale analysis utilizing national claims data suggests that EVT is a safe and efficacious therapy for AIS during pregnancy and the postpartum period.

Authors/Disclosures
Alis J. Dicpinigaitis, MD PRESENTER	Mr. Dicpinigaitis has nothing to disclose.
Chirag Gandhi (Westchester Medical Center)	Chirag Gandhi has nothing to disclose.
Fawaz Al-Mufti, MD (Westchester Medical Center at New York Medical College)	Dr. Al-Mufti has received personal compensation in the range of $0-$499 for serving as a Consultant for Stryker. Dr. Al-Mufti has received personal compensation in the range of $0-$499 for serving as a Consultant for Cerenovus. Dr. Al-Mufti has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Revalesio .

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