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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| Format: | Article |
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MDPI AG
2022-12-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/24/7433 |
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| author | Yan Li Natalie van Landeghem Aydin Demircioglu Martin Köhrmann Philipp Dammann Marvin Darkwah Oppong Ramazan Jabbarli Jens Matthias Theysohn Jens-Christian Altenbernd Hanna Styczen Michael Forsting Isabel Wanke Benedikt Frank Cornelius Deuschl |
| author_facet | Yan Li Natalie van Landeghem Aydin Demircioglu Martin Köhrmann Philipp Dammann Marvin Darkwah Oppong Ramazan Jabbarli Jens Matthias Theysohn Jens-Christian Altenbernd Hanna Styczen Michael Forsting Isabel Wanke Benedikt Frank Cornelius Deuschl |
| author_sort | Yan Li |
| collection | DOAJ |
| 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; <i>p</i> = 0.004) and complete reperfusion (TICI 3) (OR 0.035; 95% CI 0.003–0.378; <i>p</i> = 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, <i>p</i> = 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, <i>p</i> = 0.745) (OR 1.305; 95% CI 0.338–5.041, <i>p</i> = 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. |
| first_indexed | 2024-03-09T16:16:26Z |
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| id | doaj.art-0789c7a7d3564f5ea94824a2db79f5cb |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T16:16:26Z |
| publishDate | 2022-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-0789c7a7d3564f5ea94824a2db79f5cb2023-11-24T15:45:31ZengMDPI AGJournal of Clinical Medicine2077-03832022-12-011124743310.3390/jcm11247433Predictors of Symptomatic Intracranial Hemorrhage after Endovascular Thrombectomy in Acute Ischemic Stroke Patients with Anterior Large Vessel Occlusion—Procedure Time and Reperfusion Quality DetermineYan Li0Natalie van Landeghem1Aydin Demircioglu2Martin Köhrmann3Philipp Dammann4Marvin Darkwah Oppong5Ramazan Jabbarli6Jens Matthias Theysohn7Jens-Christian Altenbernd8Hanna Styczen9Michael Forsting10Isabel Wanke11Benedikt Frank12Cornelius Deuschl13Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Hufelandstrasse 55, 45147 Essen, GermanyInstitute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Hufelandstrasse 55, 45147 Essen, GermanyInstitute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Hufelandstrasse 55, 45147 Essen, GermanyDepartment of Neurology and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University Hospital Essen, Hufelandstrasse 55, 45147 Essen, GermanyDepartment of Neurosurgery and Spine Surgery, University Hospital Essen, Hufelandstrasse 55, 45147 Essen, GermanyDepartment of Neurosurgery and Spine Surgery, University Hospital Essen, Hufelandstrasse 55, 45147 Essen, GermanyDepartment of Neurosurgery and Spine Surgery, University Hospital Essen, Hufelandstrasse 55, 45147 Essen, GermanyInstitute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Hufelandstrasse 55, 45147 Essen, GermanyInstitute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Hufelandstrasse 55, 45147 Essen, GermanyInstitute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Hufelandstrasse 55, 45147 Essen, GermanyInstitute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Hufelandstrasse 55, 45147 Essen, GermanyInstitute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Hufelandstrasse 55, 45147 Essen, GermanyDepartment of Neurology and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University Hospital Essen, Hufelandstrasse 55, 45147 Essen, GermanyInstitute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Hufelandstrasse 55, 45147 Essen, GermanyPurpose: 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; <i>p</i> = 0.004) and complete reperfusion (TICI 3) (OR 0.035; 95% CI 0.003–0.378; <i>p</i> = 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, <i>p</i> = 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, <i>p</i> = 0.745) (OR 1.305; 95% CI 0.338–5.041, <i>p</i> = 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.https://www.mdpi.com/2077-0383/11/24/7433brainstrokesICHEVTthrombectomyLVO |
| spellingShingle | Yan Li Natalie van Landeghem Aydin Demircioglu Martin Köhrmann Philipp Dammann Marvin Darkwah Oppong Ramazan Jabbarli Jens Matthias Theysohn Jens-Christian Altenbernd Hanna Styczen Michael Forsting Isabel Wanke Benedikt Frank Cornelius Deuschl Predictors of Symptomatic Intracranial Hemorrhage after Endovascular Thrombectomy in Acute Ischemic Stroke Patients with Anterior Large Vessel Occlusion—Procedure Time and Reperfusion Quality Determine Journal of Clinical Medicine brain stroke sICH EVT thrombectomy LVO |
| 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 | brain stroke sICH EVT thrombectomy LVO |
| url | https://www.mdpi.com/2077-0383/11/24/7433 |
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