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Influence of cerebral microbleeds on mechanical thrombectomy outcomes

In ischemic stroke patients undergoing endovascular treatment (EVT), we aimed to test the hypothesis that cerebral microbleeds (CMBs) are associated with clinical outcomes, while estimating the mediating effects of hemorrhagic transformation (HT), small-vessel disease burden (white matter hyperinten...

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Autores principales: Lee, Seong-Joon, Hwang, Yang-Ha, Hong, Ji Man, Choi, Jin Wook, Park, Ji Hyun, Park, Bumhee, Kang, Dong-Hun, Kim, Yong-Won, Kim, Yong-Sun, Hong, Jeong-Ho, Yoo, Joonsang, Kim, Chang-Hyun, Sohn, Sung-Il, Lee, Jin Soo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8901625/
https://www.ncbi.nlm.nih.gov/pubmed/35256626
http://dx.doi.org/10.1038/s41598-022-07432-9
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author Lee, Seong-Joon
Hwang, Yang-Ha
Hong, Ji Man
Choi, Jin Wook
Park, Ji Hyun
Park, Bumhee
Kang, Dong-Hun
Kim, Yong-Won
Kim, Yong-Sun
Hong, Jeong-Ho
Yoo, Joonsang
Kim, Chang-Hyun
Sohn, Sung-Il
Lee, Jin Soo
author_facet Lee, Seong-Joon
Hwang, Yang-Ha
Hong, Ji Man
Choi, Jin Wook
Park, Ji Hyun
Park, Bumhee
Kang, Dong-Hun
Kim, Yong-Won
Kim, Yong-Sun
Hong, Jeong-Ho
Yoo, Joonsang
Kim, Chang-Hyun
Sohn, Sung-Il
Lee, Jin Soo
author_sort Lee, Seong-Joon
collection PubMed
description In ischemic stroke patients undergoing endovascular treatment (EVT), we aimed to test the hypothesis that cerebral microbleeds (CMBs) are associated with clinical outcomes, while estimating the mediating effects of hemorrhagic transformation (HT), small-vessel disease burden (white matter hyperintensities, WMH), and procedural success. From a multicenter EVT registry, patients who underwent pretreatment MR imaging were analyzed. They were trichotomized according to presence of CMBs (none vs. 1–4 vs. ≥ 5). The association between CMB burden and 3-month mRS was evaluated using multivariable ordinal logistic regression, and mediation analyses were conducted to estimate percent mediation. Of 577 patients, CMBs were present in 91 (15.8%); 67 (11.6%) had 1–4 CMBs, and 24 (4.2%) had ≥ 5. Increases in CMBs were associated with hemorrhagic complications (β = 0.27 [0.06–0.047], p = 0.010) in multivariable analysis. The CMB effect on outcome was partially mediated by post-procedural HT degree (percent mediation, 14% [0–42]), WMH (23% [7–57]) and lower rates of successful reperfusion (6% [0–25]). In conclusion, the influence of CMBs on clinical outcomes is mediated by small-vessel disease burden, post-procedural HT, and lower reperfusion rates, listed in order of percent mediation size.
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spelling pubmed-89016252022-03-08 Influence of cerebral microbleeds on mechanical thrombectomy outcomes Lee, Seong-Joon Hwang, Yang-Ha Hong, Ji Man Choi, Jin Wook Park, Ji Hyun Park, Bumhee Kang, Dong-Hun Kim, Yong-Won Kim, Yong-Sun Hong, Jeong-Ho Yoo, Joonsang Kim, Chang-Hyun Sohn, Sung-Il Lee, Jin Soo Sci Rep Article In ischemic stroke patients undergoing endovascular treatment (EVT), we aimed to test the hypothesis that cerebral microbleeds (CMBs) are associated with clinical outcomes, while estimating the mediating effects of hemorrhagic transformation (HT), small-vessel disease burden (white matter hyperintensities, WMH), and procedural success. From a multicenter EVT registry, patients who underwent pretreatment MR imaging were analyzed. They were trichotomized according to presence of CMBs (none vs. 1–4 vs. ≥ 5). The association between CMB burden and 3-month mRS was evaluated using multivariable ordinal logistic regression, and mediation analyses were conducted to estimate percent mediation. Of 577 patients, CMBs were present in 91 (15.8%); 67 (11.6%) had 1–4 CMBs, and 24 (4.2%) had ≥ 5. Increases in CMBs were associated with hemorrhagic complications (β = 0.27 [0.06–0.047], p = 0.010) in multivariable analysis. The CMB effect on outcome was partially mediated by post-procedural HT degree (percent mediation, 14% [0–42]), WMH (23% [7–57]) and lower rates of successful reperfusion (6% [0–25]). In conclusion, the influence of CMBs on clinical outcomes is mediated by small-vessel disease burden, post-procedural HT, and lower reperfusion rates, listed in order of percent mediation size. Nature Publishing Group UK 2022-03-07 /pmc/articles/PMC8901625/ /pubmed/35256626 http://dx.doi.org/10.1038/s41598-022-07432-9 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Article
Lee, Seong-Joon
Hwang, Yang-Ha
Hong, Ji Man
Choi, Jin Wook
Park, Ji Hyun
Park, Bumhee
Kang, Dong-Hun
Kim, Yong-Won
Kim, Yong-Sun
Hong, Jeong-Ho
Yoo, Joonsang
Kim, Chang-Hyun
Sohn, Sung-Il
Lee, Jin Soo
Influence of cerebral microbleeds on mechanical thrombectomy outcomes
title Influence of cerebral microbleeds on mechanical thrombectomy outcomes
title_full Influence of cerebral microbleeds on mechanical thrombectomy outcomes
title_fullStr Influence of cerebral microbleeds on mechanical thrombectomy outcomes
title_full_unstemmed Influence of cerebral microbleeds on mechanical thrombectomy outcomes
title_short Influence of cerebral microbleeds on mechanical thrombectomy outcomes
title_sort influence of cerebral microbleeds on mechanical thrombectomy outcomes
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8901625/
https://www.ncbi.nlm.nih.gov/pubmed/35256626
http://dx.doi.org/10.1038/s41598-022-07432-9
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