Abstract Number: Esoc2026a340 Outcomes of Endovascular Thrombectomy for Acute Ischemic Stroke in Patients With and Without Atrial Fibrillation: An Updated Systematic Review and Meta-Analysis

Abstract Background and aims There is no definitive characterization of how atrial fibrillation (AF) might influence the technical and clinical outcomes of mechanical thrombectomy (MT). We aimed to perform a meta-analysis to assess the effects of AF on the outcomes of MT. Methods We searched PubMed, Scopus, and Web of Science from inception to March 2025 for studies comparing outcomes of EVT for AIS among patients with and without AF. Our primary outcome was mRS scores of 0 to 2 at 90 days. Secondary outcomes included rates of TICI scores of 2b /3, 90-day mortality, and symptomatic intracranial hemorrhage (sICH). Results We included 19 studies comprising 16,094 patients (6,283 with AF versus 9,811 without AF). The rate of 90-day mRS 0-2 was significantly lower among patients with AF (OR = 0.77, 95% CI 0.64; 0.92, P 0.1), with significant heterogeneity among the included studies. Mortality was significantly higher in the AF group (OR = 1.37, 95% CI 1.14, 1.63, P 0.1). There were comparable rates of sICH and mTICI 2b-3 between patients with and without AF (OR = 1.12, 95% CI 0.98, 1.28, P = 0.08; OR = 1.11, 95% CI 0.89, 1.39, P = 0.36, respectively). Conclusions The current evidence suggests that AF might be associated with higher mortality rates and lower rates of functional independence following EVT in patients with AIS-LVO. Further research is needed to understand the potential pathophysiological mechanisms that could be implicated in these associations. Conflict of interest All Authors have nothing to disclose