Abstract：
There is limited evidence on the outcomes and safety of mechanical thrombectomy (MT) among patients with acute ischemic stroke (AIS) in the context of cardiac diseases. Our study reviews MT in AIS within the context of cardiac diseases, aiming to identify existing and emerging needs and gaps. PubMed and Scopus were searched until December 31, 2023, using a combination of cardiological diseases and \"mechanical thrombectomy\" or \"endovascular treatment\" as keywords. Study design included case reports/series, observational studies, randomized clinical trials, and meta-analyses/systematic reviews. We identified 943 articles, of which 130 were included in the review. Results were categorized according to the cardiac conditions. MT shows significant benefits in patients with atrial fibrillation (n=139) but lacks data for stroke occurring after percutaneous coronary intervention (n=2) or transcatheter aortic valve implantation (n=5). MT is beneficial in AIS attributable to infective endocarditis (n=34), although functional benefit may be limited. Controversy surrounds the functional outcomes and mortality of patients with AIS with heart failure undergoing MT (n=11). Despite technical challenges, MT appears feasible in aortic dissection cases (n=4), and in patients with left ventricular assist device or total artificial heart (n=10). Data on AIS attributable to congenital heart disease (n=4) primarily focus on pediatric cases requiring technical modifications. Treatment outcomes of MT in patients with cardiac tumors (n=8) vary because of clot consistency differences. After cardiac surgery stroke, MT may improve outcomes with early intervention (n=13). Available data outline the feasibility of MT in patients with AIS attributable to large-vessel occlusion in the context of cardiac diseases.
摘要：
关于心脏疾病背景下急性缺血性卒中（AIS）患者机械血栓切除术（MT）的结果和安全性的证据有限。我们的研究回顾了心脏病背景下的AIS中的MT，旨在确定现有和新出现的需求和差距。直到2023年12月31日，使用心脏病和“机械血栓切除术”或“血管内治疗”作为关键词的组合搜索PubMed和Scopus。研究设计包括病例报告/系列，观察性研究，随机临床试验，和荟萃分析/系统评价。我们确定了943篇文章，其中130人被列入审查范围。根据心脏状况对结果进行分类。MT在房颤患者（n=139）中显示出显着益处，但缺乏经皮冠状动脉介入治疗（n=2）或经导管主动脉瓣植入（n=5）后发生中风的数据。MT对可归因于感染性心内膜炎的AIS有益(n=34)，尽管功能益处可能有限。关于AIS伴心力衰竭患者接受MT的功能结果和死亡率的争议（n=11）。尽管技术挑战,MT在主动脉夹层病例中似乎是可行的(n=4)，以及左心室辅助装置或全人工心脏患者（n=10）。有关可归因于先天性心脏病的AIS的数据（n=4）主要集中在需要技术修改的儿科病例上。心脏肿瘤患者（n=8）的MT治疗结果因凝块一致性差异而变化。心脏手术中风后，MT可以改善早期干预的结果(n=13)。现有数据概述了MT在心脏疾病背景下可归因于大血管闭塞的AIS患者中的可行性。
