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Predictors of Symptomatic Intracranial Hemorrhage after Endovascular Thrombectomy in Acute Ischemic Stroke Patients with Anterior Large Vessel Occlusion—Procedure Time and Reperfusion Quality Determine

Purpose: We aimed to evaluate predictors of symptomatic intracranial hemorrhage (sICH) in acute ischemic stroke (AIS) patients following thrombectomy due to anterior large vessel occlusion (LVO). Methods: Data on stroke patients from January 2018 to December 2020 in a tertiary care centre were retro...

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Autores principales: Li, Yan, van Landeghem, Natalie, Demircioglu, Aydin, Köhrmann, Martin, Dammann, Philipp, Oppong, Marvin Darkwah, Jabbarli, Ramazan, Theysohn, Jens Matthias, Altenbernd, Jens-Christian, Styczen, Hanna, Forsting, Michael, Wanke, Isabel, Frank, Benedikt, Deuschl, Cornelius
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9781417/
https://www.ncbi.nlm.nih.gov/pubmed/36556049
http://dx.doi.org/10.3390/jcm11247433
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author Li, Yan
van Landeghem, Natalie
Demircioglu, Aydin
Köhrmann, Martin
Dammann, Philipp
Oppong, Marvin Darkwah
Jabbarli, Ramazan
Theysohn, Jens Matthias
Altenbernd, Jens-Christian
Styczen, Hanna
Forsting, Michael
Wanke, Isabel
Frank, Benedikt
Deuschl, Cornelius
author_facet Li, Yan
van Landeghem, Natalie
Demircioglu, Aydin
Köhrmann, Martin
Dammann, Philipp
Oppong, Marvin Darkwah
Jabbarli, Ramazan
Theysohn, Jens Matthias
Altenbernd, Jens-Christian
Styczen, Hanna
Forsting, Michael
Wanke, Isabel
Frank, Benedikt
Deuschl, Cornelius
author_sort Li, Yan
collection PubMed
description Purpose: We aimed to evaluate predictors of symptomatic intracranial hemorrhage (sICH) in acute ischemic stroke (AIS) patients following thrombectomy due to anterior large vessel occlusion (LVO). Methods: Data on stroke patients from January 2018 to December 2020 in a tertiary care centre were retrospectively analysed. sICH was defined as intracranial hemorrhage associated with a deterioration of at least four points in the National Institutes of Health Stroke Scale (NIHSS) score or hemorrhage leading to death. A smoothed ridge regression model was run to analyse the impact of 15 variables on their association with sICH. Results: Of the 174 patients (median age 77, 41.4% male), sICH was present in 18 patients. Short procedure time from groin puncture to reperfusion (per 10 min OR 1.24; 95% CI 1.071–1.435; p = 0.004) and complete reperfusion (TICI 3) (OR 0.035; 95% CI 0.003–0.378; p = 0.005) were significantly associated with a lower risk of sICH. On the contrary, successful reperfusion (TICI 3 and TICI 2b) was not associated with a lower risk of sICH (OR 0.508; 95% CI 0.131–1.975, p = 0.325). Neither the total time from symptom onset to reperfusion nor the intravenous thrombolysis was a predictor of sICH (per 10 min OR 1.0; 95% CI 0.998–1.001, p = 0.745) (OR 1.305; 95% CI 0.338–5.041, p = 0.697). Conclusion: Our findings addressed the paramount importance of short procedure time and complete reperfusion to minimize sICH risk. The total ischemic time from onset to reperfusion was not a predictor of sICH.
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spelling pubmed-97814172022-12-24 Predictors of Symptomatic Intracranial Hemorrhage after Endovascular Thrombectomy in Acute Ischemic Stroke Patients with Anterior Large Vessel Occlusion—Procedure Time and Reperfusion Quality Determine Li, Yan van Landeghem, Natalie Demircioglu, Aydin Köhrmann, Martin Dammann, Philipp Oppong, Marvin Darkwah Jabbarli, Ramazan Theysohn, Jens Matthias Altenbernd, Jens-Christian Styczen, Hanna Forsting, Michael Wanke, Isabel Frank, Benedikt Deuschl, Cornelius J Clin Med Article Purpose: We aimed to evaluate predictors of symptomatic intracranial hemorrhage (sICH) in acute ischemic stroke (AIS) patients following thrombectomy due to anterior large vessel occlusion (LVO). Methods: Data on stroke patients from January 2018 to December 2020 in a tertiary care centre were retrospectively analysed. sICH was defined as intracranial hemorrhage associated with a deterioration of at least four points in the National Institutes of Health Stroke Scale (NIHSS) score or hemorrhage leading to death. A smoothed ridge regression model was run to analyse the impact of 15 variables on their association with sICH. Results: Of the 174 patients (median age 77, 41.4% male), sICH was present in 18 patients. Short procedure time from groin puncture to reperfusion (per 10 min OR 1.24; 95% CI 1.071–1.435; p = 0.004) and complete reperfusion (TICI 3) (OR 0.035; 95% CI 0.003–0.378; p = 0.005) were significantly associated with a lower risk of sICH. On the contrary, successful reperfusion (TICI 3 and TICI 2b) was not associated with a lower risk of sICH (OR 0.508; 95% CI 0.131–1.975, p = 0.325). Neither the total time from symptom onset to reperfusion nor the intravenous thrombolysis was a predictor of sICH (per 10 min OR 1.0; 95% CI 0.998–1.001, p = 0.745) (OR 1.305; 95% CI 0.338–5.041, p = 0.697). Conclusion: Our findings addressed the paramount importance of short procedure time and complete reperfusion to minimize sICH risk. The total ischemic time from onset to reperfusion was not a predictor of sICH. MDPI 2022-12-15 /pmc/articles/PMC9781417/ /pubmed/36556049 http://dx.doi.org/10.3390/jcm11247433 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Li, Yan
van Landeghem, Natalie
Demircioglu, Aydin
Köhrmann, Martin
Dammann, Philipp
Oppong, Marvin Darkwah
Jabbarli, Ramazan
Theysohn, Jens Matthias
Altenbernd, Jens-Christian
Styczen, Hanna
Forsting, Michael
Wanke, Isabel
Frank, Benedikt
Deuschl, Cornelius
Predictors of Symptomatic Intracranial Hemorrhage after Endovascular Thrombectomy in Acute Ischemic Stroke Patients with Anterior Large Vessel Occlusion—Procedure Time and Reperfusion Quality Determine
title Predictors of Symptomatic Intracranial Hemorrhage after Endovascular Thrombectomy in Acute Ischemic Stroke Patients with Anterior Large Vessel Occlusion—Procedure Time and Reperfusion Quality Determine
title_full Predictors of Symptomatic Intracranial Hemorrhage after Endovascular Thrombectomy in Acute Ischemic Stroke Patients with Anterior Large Vessel Occlusion—Procedure Time and Reperfusion Quality Determine
title_fullStr Predictors of Symptomatic Intracranial Hemorrhage after Endovascular Thrombectomy in Acute Ischemic Stroke Patients with Anterior Large Vessel Occlusion—Procedure Time and Reperfusion Quality Determine
title_full_unstemmed Predictors of Symptomatic Intracranial Hemorrhage after Endovascular Thrombectomy in Acute Ischemic Stroke Patients with Anterior Large Vessel Occlusion—Procedure Time and Reperfusion Quality Determine
title_short Predictors of Symptomatic Intracranial Hemorrhage after Endovascular Thrombectomy in Acute Ischemic Stroke Patients with Anterior Large Vessel Occlusion—Procedure Time and Reperfusion Quality Determine
title_sort predictors of symptomatic intracranial hemorrhage after endovascular thrombectomy in acute ischemic stroke patients with anterior large vessel occlusion—procedure time and reperfusion quality determine
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9781417/
https://www.ncbi.nlm.nih.gov/pubmed/36556049
http://dx.doi.org/10.3390/jcm11247433
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