Abstract Details

Title Incidence of Access Site Complications in Patients Receiving Tenecteplase as Bridging Therapy to Endovascular Treatment

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P9 - Poster Session 9 (5:30 PM-6:30 PM)

Poster/Presentation
Number 13-010

Background Mechanical thrombectomy (EVT) is the standard of endovascular care for acute ischemic stroke secondary to large vessel occlusion. Alteplase in conjunction with EVT has a strong safety profile with low incidence of complications including groin hematoma.

Objective

Our objective was to evaluate the incidence of groin hematoma in EVT following bridging therapy tenecteplase (TNK) as this is not well-described in the literature.

Design/Methods Retrospective review of prospectively collected data for patients with acute ischemic stroke who underwent mechanical thrombectomy at a University Hospital. Incidence of access site complications including groin hematoma, retroperitoneal hematoma, blood loss and femoral artery pseudoaneurysm with or without the need for surgical intervention were reviewed. Rates of use of other antithrombotic agents were also noted. Social Science Statistics was used for data analysis.

Results From October of 2020 to April of 2021, of 348 ischemic stroke patients, 16 had LVO identified on CT and received TNK prior to mechanical thrombectomy (Females = 6; age, 63.25 95% CI [54.9207, 71.5793]); Mean weight =78kg, 95% CI [67.68, 88.32]). Five subjects (31.25%) received intra-arterial non-thrombolytics. None received intra-arterial thrombolytics. Three patients (18.75%) received therapeutic heparin during the procedure. Four patients (25%) were started on non-thrombolytic infusion during the periprocedural period. One subject (6.25%) was started on stroke nomogram heparin infusion less than 24 hours post-intervention. One subject (6.25%) developed groin hematoma that did not require intervention. This subject received intra-arterial non-thrombolytics during procedure and IV non-thrombolytics during the peri-procedural period.

Conclusions Our single center experience with TNK outside of the clinical trial setting with concomitant use of other antithrombotics suggests safety of bridging strategy. Larger prospective ‘real-life’ studies are required to validate our findings.

Authors/Disclosures
PRESENTER	No disclosure on file
Nasar Ali, DO (Neuroscience Center)	Dr. Ali has nothing to disclose.
Sindhu Sahito, MD (JFK Medical Center)	Dr. Sahito has nothing to disclose.
Abdallah O. Amireh, MD (HMH JFK Medical Center)	Dr. Amireh has nothing to disclose.
	No disclosure on file
Spozhmy Panezai, MD (JFK Medical Center)	Dr. Panezai has nothing to disclose.
Haralabos Zacharatos, MD	Dr. Zacharatos has nothing to disclose.
Siddhart K. Mehta, MD	Dr. Mehta has nothing to disclose.
Farah Y. Fourcand, MD (Cleveland Clinic Indian River)	Dr. Fourcand has nothing to disclose.
Jawad F. Kirmani, MD (RWJBarnabas Medical)	Dr. Kirmani has nothing to disclose.