1. Predictors for Symptomatic Intracranial Hemorrhage After Endovascular Treatment of Acute Ischemic Stroke
- Author
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Yonggang Hao, Dong Yang, Huaiming Wang, Wenjie Zi, Meng Zhang, Yu Geng, Zhiming Zhou, Wei Wang, Haowen Xu, Xiguang Tian, Penghua Lv, Yuxiu Liu, Yunyun Xiong, Xinfeng Liu, Gelin Xu, Chengchun Liu, Zongjie Shi, Jinhua Zhang, Hang Lin, Min Lin, Zhen Hu, Xiaorong Deng, Yue Wan, Jiandong Zhang, Zhonghua Shi, Mirui Qu, Xianjun Huang, Tao Quan, Sheng Guan, Lin Chen, Xiaobo Li, Shuiping Wang, Shiquan Yang, Wenhua Liu, Dan Wei, Zhen Wang, Xintong Liu, Fuqiang Guo, Shu Yang, Dequan Zheng, Xinyu Wu, Youfu Zeng, Mingyi Tu, Ping Jin, Yong Liu, Hua Li, Jiayang Fang, and Guodong Xiao
- Subjects
Male ,China ,medicine.medical_specialty ,Arterial Occlusive Diseases ,030204 cardiovascular system & hematology ,Brain Ischemia ,Brain ischemia ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Humans ,Medicine ,Registries ,Endovascular treatment ,Stroke ,Acute ischemic stroke ,Aged ,Thrombectomy ,Aged, 80 and over ,Advanced and Specialized Nursing ,Groin ,business.industry ,Middle Aged ,medicine.disease ,Collateral circulation ,Surgery ,medicine.anatomical_structure ,Cardiology ,Female ,Stents ,Cerebral Arterial Diseases ,Neurology (clinical) ,Cardiology and Cardiovascular Medicine ,business ,Intracranial Hemorrhages ,030217 neurology & neurosurgery - Abstract
Background and Purpose— Symptomatic intracranial hemorrhage (SICH) pose a major safety concern for endovascular treatment of acute ischemic stroke. This study aimed to evaluate the risk and related factors of SICH after endovascular treatment in a real-world practice. Methods— Patients with stroke treated with stent-like retrievers for recanalizing a blocked artery in anterior circulation were enrolled from 21 stroke centers in China. Intracranial hemorrhage was classified as symptomatic and asymptomatic ones according to Heidelberg Bleeding Classification. Logistic regression was used to identify predictors for SICH. Results— Of the 632 enrolled patients, 101 (16.0%) were diagnosed with SICH within 72 hours after endovascular treatment. Ninety-day mortality was higher in patients with SICH than in patients without SICH (65.3% versus 18.8%; P 0.83 (odds ratio [OR], 2.07; 95% confidence interval [CI], 1.24–3.46), pretreatment Alberta Stroke Program Early Computed Tomography Score of 270 minutes (OR, 1.70; 95% CI, 1.03–2.80), >3 passes with retriever (OR, 2.55; 95% CI, 1.40–4.65) were associated with SICH after endovascular treatment. Conclusions— Incidence of SICH after thrombectomy is higher in Asian patients with acute ischemic stroke. Cardioembolic stroke, poor collateral circulation, delayed endovascular treatment, multiple passes with stent retriever device, lower pretreatment Alberta Stroke Program Early Computed Tomography Score, higher baseline neutrophil ratio may increase the risk of SICH.
- Published
- 2017