Lapeña, PauUrra, XabierLlopis, JaumeHernández-Meneses, MartaCuervo Requena, GuillermoMaisterra, OlgaEscrihuela Vidal, FrancescPrats-Sánchez, LuisSáez, CarmenOlmos, CarmenHernández-Fernández, FranciscoWerner, MarianoPérez de la Ossa, NataliaQuintana, EduardMoreno Camacho, Ma. AsunciónChamorro Sánchez, ÁngelMiró Meda, José M. (José María), 1956-Mechanical Thrombectomy in IE InvestigatorsCat-SCR Consortium2026-01-282026-02-062025-02-071198-743Xhttps://hdl.handle.net/2445/226367Objectives: Acute ischaemic strokes (stroke) are frequent and severe extracardiac complications in infective endocarditis (IE). Because intravenous thrombolysis (i.v.-thrombolysis) is contraindicated, mechanical thrombectomy (thrombectomy) offers potential benefits. We aimed to compare thrombectomy efficacy and safety between IE-related and general stroke cases. Methods: Multicentre study of consecutive IE cases treated with thrombectomy at nine stroke centres in Spain from 2011 to 2022. Using propensity score matching, 50 IE cases were 1:4 matched with patients without IE stroke (n = 200). Efficacy was defined by successful recanalization rates (modified treatment in cerebral ischaemia scale ≥2 b), neurological improvement at 24 hours (decrease of National Institutes of Health Stroke Scale compared with baseline), and good neurological outcome rates at 3 months (modified Rankin scale ≤2). Safety was assessed by intracranial haemorrhage (IC-haemorrhage), symptomatic IC-haemorrhage, crude mortality, and stroke-related mortality. Results: Among 54 IE cases, 50 were matched with 200 controls. Successful recanalization was similarly achieved in both groups (76% vs. 83%). Median National Institutes of Health Stroke Scale at 24 hours was comparable, with analogous rates of neurological improvement (78% vs. 78%), and early dramatic response (48% vs. 46.5%). No differences were seen regarding IC-haemorrhage rates, except for when prior i.v.-thrombolysis was given. Although crude mortality was higher in the IE cohort, no differences were seen in stroke-related mortality (12% vs. 15%). At 3 months, modified Rankin scale scores of the two groups were superimposable. Discussion: Thrombectomy in IE is as effective and safe as in patients without IE, and prior i.v.-thrombolysis could decrease the procedural safety. Clinical practice guidelines may consider including the recommendation to perform thrombectomy alone in IE-related stroke.9 p.application/pdfeng(c) Lapeña, P. et al., 2025EndocarditisEmbòlia i trombosi cerebralComplicacions (Medicina)EndocarditisCerebral embolism and thrombosisComplications (Medicine)info:eu-repo/semantics/article7554922026-01-28info:eu-repo/semantics/openAccess39924109