{
  "abstract": "Background Left ventricular assist devices (LVADs) are used as definitive therapy or as a bridge to heart transplant in patients with advanced heart failure. Thromboembolic complications such as acute ischemic stroke (AIS) are common among patients with LVAD support. This study aims to evaluate the current evidence on the efficacy and safety of mechanical thrombectomy (MT) in patients with AIS due to large vessel occlusions (LVO) and LVAD-support.Methods A comprehensive systematic review was conducted in PubMed, Embase, and Scopus to find observational studies with reports of ≥5 MTs in adult patients with LVAD support (PROSPERO registration code CRD42024597541). Rates of successful and complete reperfusion, favorable functional outcomes at 90 days (modified Rankin Scale (mRS) 0–2 or equal to pre-stroke mRS), mortality at 90 days, any intracerebral hemorrhage (ICH) and symptomatic ICH (sICH) were pooled using generalized linear mixed models.Results Eight studies were included with data from 51 patients and 62 MTs. The rate of successful reperfusion was 87.4% (95% CI 62.5% to 96.6%) and complete reperfusion rate was 57.3% (95% CI 35.1% to 76.9%). Rate of favorable functional recovery was 62.5% (95% CI 42.2% to 79.2%). Rate of sICH was 6.4% (95% CI 0.9% to 34.0%). Mortality rate was 16.7% (95% CI 7.1% to 34.7%). Between 25–40% of patients who were waiting for a heart transplant before their stroke received a heart transplant after MT.Conclusions MT for the emergent treatment of AIS in the setting of LVAD is relatively safe and efficacious for achieving successful reperfusion and good functional recovery.",
  "authors": [
    {
      "affiliations": [
        "Tehran University of Medical Sciences, Sina Trauma and Surgery Research Center, Tehran, Iran (the Islamic Republic of)"
      ],
      "name": "Seyed Behnam Jazayeri"
    },
    {
      "affiliations": [
        "Department of Neurology, Baptist Health Lexington, Lexington, Kentucky, USA"
      ],
      "name": "Omar M Al-Janabi"
    },
    {
      "affiliations": [
        "Royal College of Surgeons in Ireland, Busaiteen, Bahrain"
      ],
      "name": "Aysha Alateya"
    },
    {
      "affiliations": [
        "Department of Neurology, New York Medical College, Valhalla, New York, USA"
      ],
      "name": "Sara Muhammad"
    },
    {
      "affiliations": [
        "Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA",
        "Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA"
      ],
      "name": "Sherief Ghozy"
    },
    {
      "affiliations": [
        "Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA"
      ],
      "name": "Alejandro A Rabinstein"
    },
    {
      "affiliations": [
        "Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA",
        "Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA"
      ],
      "name": "Ramanathan Kadirvel"
    },
    {
      "affiliations": [
        "Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA"
      ],
      "name": "David F Kallmes"
    }
  ],
  "title": "Efficacy and safety of mechanical thrombectomy in patients with acute ischemic stroke and left ventricular assist device: review of the literature and meta-analysis",
  "uid": "1e6da58b-a10a-54cb-9c6c-30799b2517bb"
}