Endovascular therapy complications not dictated by timing of administration

The risk of procedural complications related to endovascular therapy (EVT) does not vary by the time window it is given, but short-term outcomes seem compromised with late EVT in the presence of complications, according to a study.

The retrospective study included 695 acute ischaemic stroke patients receiving EVT in the Acute Stroke Registry and Analysis of Lausanne. Procedural EVT complications were evaluated in the early (<6 hours) versus late (6–24 hours) window and correlated with short-term clinical outcome.

Of the patients, 202 (29.1 percent) received EVT in the late window and 113 (16.3 percent) had at least one procedural complication.

The incidence of overall procedural complications did not differ between early and late EVT (16.2 percent vs 16.3 percent; p=0.90). Procedural complications were associated with a significantly less favourable short-term outcome, as indicated by the absence of improvement in the National Institutes of Health Stroke Scale, in late EVT (delta-National Institutes of Health Stroke Scale-24 hours, −2.5 vs 2; p=0.01).

EVT in acute ischemic stroke is effective in the late time window in some patients. However, the findings suggest that the presence of complications after late EVT negatively affects short-term outcomes.

Periprocedural complications associated with endovascular stroke treatment are classified as haemorrhagic complications, procedure-/device-related, puncture site complications, and late-onset events including vascular stenosis. [Br J Radiol 2016;89:20150267]