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ESMINT-EYMINT Survey: Heparin use in stroke thrombectomy

19 Dec 2022   Category/ies: Standards

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Dear colleagues,

This survey is designed to obtain an overview of the use of any heparin in endovascular thrombectomy practices in Europe. It is supported by the ESMINT society and EYMINT research collaborative group.

Heparin during endovascular thrombectomy (EVT) for acute ischemic stroke (AIS) and its impact on functional outcome is often underestimated, which is reflected by the results of the MR CLEAN MED trial(1). The use of heparin in infusion bags, that flushes the catheters during the treatment, is not considered in the recent trials regarding the impact of antithrombotics during EVT(1,2) and could have influenced the results.

However, the heparin dose during EVT (i.e., as IV bolus and/or as heparin in flush fluids infusion bags) has high inter-individual variability, mainly due to procedural factors (e.g., whether or not an IV bolus is given, the number of infusion bags used, the timing of connecting the bag, drip-rate). In order to truly analyze the impact on functional outcome after EVT, this variability should first be investigated.

This survey will provide more insight in how European interventionists consider their heparin administration during EVT. Data will be treated anonymously and will be used for further research projects regarding heparin (flush) use in EVT for AIS and its impact on outcome.

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  • Van der Steen W, van de Graaf RA, Chalos V, et al. Safety and efficacy of aspirin, unfractionated heparin, both, or neither during endovascular stroke treatment (MR CLEAN-MED): an open-label, multicentre, randomised controlled trial. The Lancet. 2022;399(10329):1059-1069. doi:10.1016/s0140-6736(22)00014-9
  • LeCouffe NE, Kappelhof M, Treurniet KM, et al. A Randomized Trial of Intravenous Alteplase before Endovascular Treatment for Stroke. N Engl J Med. Nov 11 2021;385(20):1833-1844. doi:10.1056/NEJMoa2107727