Endovascular treatment for ischaemic stroke patients with and without atrial fibrillation, and the effects of adjunctive pharmacotherapy: a narrative review.
Muath AlobaidaGregory Y H LipDeirdre A LaneDimitrios SagrisAzmil H Abdul-RahimStephanie L HarrisonPublished in: Expert opinion on pharmacotherapy (2022)
There is little evidence from randomised controlled trials on the effect of atrial fibrillation on stroke outcomes following EVT and the safety and efficacy of atrial fibrillation treatment in the peri-EVT such as tirofiban or Intravenous thrombolysis with Non-vitamin K Antagonist Oral Anticoagulant. The available evidence from observational studies on atrial fibrillation and EVT outcomes is inconsistent, but factors such as procedural EVT devices, the centre volume, clinician experience, stroke recognition, and inclusion criteria of studies have all been associated with poorer clinical outcomes. Enhancing the clinical network among prehospital and hospitals will facilitate direct transfer to EVT centres, reducing stroke onset to EVT time and optimising stroke outcomes.
Keyphrases
- atrial fibrillation
- oral anticoagulants
- catheter ablation
- left atrial
- left atrial appendage
- direct oral anticoagulants
- heart failure
- endovascular treatment
- percutaneous coronary intervention
- healthcare
- type diabetes
- high dose
- metabolic syndrome
- coronary artery disease
- acute ischemic stroke
- brain injury
- left ventricular
- venous thromboembolism
- blood brain barrier
- case control
- emergency medical
- trauma patients