Study pinpoints risk factors for thrombectomy-related stroke

Posterior-circulation arterial supply and the presence of arteriovenous malformation contribute to an increased risk of perioperative stroke among patients undergoing endovascular therapy, according to a study.

Researchers used the National Institute of Neurological Disorders and Stroke database to obtain all data relating to patients who participated in the ARUBA* trial. These data included demographics, interventions undertaken, and timing of stroke.

A total of 64 ARUBA patients were included in the analysis. There were 159 interventions performed, of which 26 (16 percent) led to stroke within 48 hours of treatment.

Among patients who underwent endovascular intervention, perioperative stroke risk was associated with posterior cerebral artery supply (adjusted odds ratio [OR], 4.42, 95 percent confidence interval [CI], 1.23–15.9; p=0.02) and Spetzler-Martin grades 2 and 3 arteriovenous malformation (adjusted OR, 7.76, 95 percent CI, 1.20–50.3; p=0.03 and adjusted OR, 9.64, 95 percent CI, 1.36–68.4; p=0.04, respectively).

Of note, patients treated in the US or Germany were at lower risk of stroke compared with those treated in other countries (adjusted OR, 0.18, 95 percent CI, 0.04–0.82; p=0.02).

Improved understanding of risks within the ARUBA cohort, which evaluated outcomes in treated and untreated patients with unruptured arteriovenous malformation, can guide clinicians in the management of unruptured brain arteriovenous malformation.

*A Randomized Trial of Unruptured Brain Arteriovenous Malformations