Table 4.
Infective Endocarditis and Mechanical Thrombectomy
| Reference | Study type | Total No. of patients | Age, y | Patients treated with MT, n (%) | Patients with mRS score 0–2 at 90 d, n (%) | Patients with mRS score of 6 at 90 d, n (%) | Patients with sICH, n (%) | Patients with succesful recanalization (mTICI 2b–3), n (%) | Summary of study findings |
|---|---|---|---|---|---|---|---|---|---|
| D'Anna et al 2020 74 | Literature review of 19 studies | 30 | Median, 67 (IQR: 32–75) | 30 (100) | 14 (46.7) | 7 (23.3) | 4 (13.3) | 13 (43.3) | MT in patients with IE should be considered case by case as safety not established yet |
| Feil et al 2021 94 | Retrospective observational multicenter cohort study | 6635 Patients with AIS undergoing MT, of whom 159 included in the final analysis (55 with IE, 34.6%, 104 matched controls with cardioembolism, 65.4%) |
Cardioembolism: mean, 66.5 (±SD: 13.4) IE: mean, 69.0 (±SD: 13.3) |
159 (100) |
Cardioembolism: 45 (43.3) IE: 11 (20.0)* |
Cardioembolism: 30 (28.8) IE: 33 (60.0)* |
Cardioembolism: 21 (20.2) IE: 14 (25.5) |
CE: 91 (87.5) IE: 41 (74.5)* |
MT is associated with worse clinical outcomes in patients with AIS with IE vs cardioembolism |
| Marnat et al 2021 95 | Retrospective observational multicenter cohort study | 112 Patients with AIS undergoing MT, of whom 28 (25%) with IE |
Cardioembolism: mean, 61.4 (±SD: 16.5) IE: mean, 59.2 (±SD: 17.6) |
112 (100) |
Cardioembolism: 39/77 (50.6) IE: 7/27 (25.9)* |
Cardioembolism: 15/77 (19.5) IE: 7/27 (25.9) |
Cardioembolism: 4/77 (5.2) IE: 2/25 (8.0) |
Cardioembolism: 80/84 (95.2) IE: 24/28 (85.7) |
MT is associated with worse clinical outcomes in patients with AIS with IE vs cardioembolism |
| Bolognese et al 2018 79 | Case report and literature review of 13 cases | 14 | Mean, 49 (range: 24–78) | 14 (100) | NA | NA | 0 (0) | NA | MT may be considered in AIS attributable to IE |
| Mowla et al 2022 96 | Meta‐analysis of 6 studies | 120 |
Mean, 57.2 Median, 75.5 |
120 (100) | NA | 50/84 (59.5) | 31 (25.8) | 89 (74.2) | MT may be considered in AIS attributable to IE |
| Marquardt et al 2019 69 | Literature review and case series | 40 |
No MT: median, 61.5 (IQR: 48–69) MT: median, 48.5 (37.5–67) |
21 (52.5) |
No MT: 7/19 (37) MT: 13/21 (62) |
Only intrahospital mortality data available No MT: 4/19 (21) MT: 4/21 (19) |
No MT: 8/19 (42) MT: 2/17 (12) |
NA | MT may be considered in AIS attributable to IE |
AIS indicates acute ischemic stroke; IE, infective endocarditis; IQR, interquartile range; mRS, modified Rankin Scale; MT, mechanical thrombectomy; mTICI, modified Treatment in Cerebral Ischemia; NA, not available; and sICH, symptomatic intracranial hemorrhage.
Significantly different at P<0.05.