Significant morbidity and mortality associated with peri-operative stroke even in the era of mechanical thrombectomy

Perioperative strokes (POS) are rare but serious complications and usually cannot be treated with IV thrombolysis depending on the surgical site and of the delay from surgery. A recent study aims to investigate the safety and effectiveness of mechanical thrombectomy in this group of patients.

The investigators conducted a retrospective, case-controlled study on 25 perioperative stroke patients and 50 baseline-matched controls. There was no difference in technical results including rate of TICI 2B/3 reperfusion (76% vs. 86%, p=0.22) and major complications (4% vs. 6%, p=0.5). However, good clinical outcome (mRS =0-2) at 3 months was achieved in 33.3% of perioperative strokes vs. 56.5% in controls (p=0.055) and there was a significant difference in mortality rate at 3 months (33.3% vs. 4.2%, p=0.002). The authors conclude that mechanical thrombectomy procedure can be safely performed in the perioperative stroke patients, and these patients are associated with increased morbidity and mortality likely attributable to underlying disease that required surgery in the first place.