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Current Cardiology Reports
Erschienen in: Current Cardiology Reports 12/2023

03.11.2023 | Cardiovascular Critical Care (A Higgins and R Lee, Section Editors)

Stroke and Mechanical Circulatory Support in Adults

verfasst von: David J. Bae, Joshua Z. Willey, Chinwe Ibeh, Melana Yuzefpolskaya, Paolo C. Colombo

Erschienen in: Current Cardiology Reports | Ausgabe 12/2023

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Abstract

Purpose of the Review

Short-term and durable mechanical circulatory support (MCS) devices represent life-saving interventions for patients with cardiogenic shock and end-stage heart failure. This review will cover the epidemiology, risk factors, and treatment of stroke in this patient population.

Recent Findings

Short-term devices such as intra-aortic balloon pump, Impella, TandemHeart, and Venoatrial Extracorporal Membrane Oxygenation, as well as durable continuous-flow left ventricular assist devices (LVADs), improve cardiac output and blood flow to the vital organs. However, MCS use is associated with high rates of complications, including ischemic and hemorrhagic strokes which carry a high risk for death and disability. Improvements in MCS technology have reduced but not eliminated the risk of stroke. Mitigation strategies focus on careful management of anti-thrombotic therapies. While data on therapeutic options for stroke are limited, several case series reported favorable outcomes with thrombectomy for ischemic stroke patients with large vessel occlusions, as well as with reversal of anticoagulation for those with hemorrhagic stroke.

Summary

Stroke in patients treated with MCS is associated with high morbidity and mortality. Preventive strategies are targeted based on the specific form of MCS. Improvements in the design of the newest generation device have reduced the risk of ischemic stroke, though hemorrhagic stroke remains a serious complication.
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Metadaten
Titel
Stroke and Mechanical Circulatory Support in Adults
verfasst von
David J. Bae
Joshua Z. Willey
Chinwe Ibeh
Melana Yuzefpolskaya
Paolo C. Colombo
Publikationsdatum
03.11.2023
Verlag
Springer US
Erschienen in
Current Cardiology Reports / Ausgabe 12/2023
Print ISSN: 1523-3782
Elektronische ISSN: 1534-3170
DOI
https://doi.org/10.1007/s11886-023-01985-5

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