Mechanical Thrombectomy Outcomes in COVID-19 Patients With Acute Ischemic Stroke: A Narrative Review

Neurologist. 2021 Nov 4;26(6):261-267. doi: 10.1097/NRL.0000000000000360.

Abstract

Background: Coronavirus disease 2019 (COVID-19) has been shown to associate with increased risk of thromboembolic events. Mechanical thrombectomy (MT) has long been used to effectively manage those with large-vessel occlusive (LVO) stroke and has similarly been implemented in the management of stroke in COVID-19 patients.

Review summary: The COVID-19 pandemic took the health care sector by a storm. Thus, less is known about MT outcomes in this population and evidence suggesting poor outcomes postthrombectomy for COVID-19 patients is accumulating. We provide a narrative on some of the published studies on the outcomes of MT in COVID-19 patients with LVO between March 2020 and February 2021. A description of patient characteristics, risk factors, COVID-19 infection severity, stroke features and thrombectomy success in this population is also presented as data from several studies show that LVO in COVID-19 patients may have some distinguishing characteristics that make management more challenging.

Conclusions: The effect of COVID-19 on the long-term prognosis of stroke patients after thrombectomy is yet to be determined. The accumulating evidence from current studies indicates a negative impact of COVID-19 on outcomes in acute ischemic stroke patients who receive MT, irrespective of timely, successful angiographic recanalization. This review may help alert clinicians of some of the COVID-19-specific postthrombectomy challenges.

Publication types

  • Review

MeSH terms

  • Brain Ischemia* / complications
  • COVID-19*
  • Humans
  • Ischemic Stroke*
  • Pandemics
  • Retrospective Studies
  • SARS-CoV-2
  • Stroke* / surgery
  • Thrombectomy
  • Treatment Outcome