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Forschungsdatenbank PMU-SQQUID

Risk factors of intracranial hemorrhage after mechanical thrombectomy of anterior circulation ischemic stroke.
Neuberger, U; Kickingereder, P; Schonenberger, S; Schieber, S; Ringleb, PA; Bendszus, M; Pfaff, J; Mohlenbruch, MA
Neuroradiology. 2019; 61(4):461-469
Originalarbeiten (Zeitschrift)

PMU-Autor/inn/en

Pfaff Johannes

Abstract

Purpose Intracranial hemorrhage (ICH) is a potentially severe complication after mechanical thrombectomy (MT). Here, we investigated risk factors for the occurrence of any and symptomatic ICH after MT due to large-vessel occlusion of the anterior circulation. Methods Consecutive patients with acute ischemic anterior circulation stroke with large-vessel occlusion undergoing MT were analyzed. ICH was categorized according to the Heidelberg Bleeding Classification. Forty-three procedural and clinical parameters were analyzed using univariate tests and multivariate logistic regressions. Results Of 612 patients, any ICH was detected in 195 (31.9%), while 27 (4.4%) developed a symptomatic ICH. Infarct size >1/3 of vascular territory in control imaging (OR 2.18, 95% CI 1.45-3.21), higher serum glucose levels (OR 1.23 for change of 15unitsmg/dL, 95% CI 1.10-1.39), and higher thrombectomy maneuver count (OR 1.21, 95% CI 1.11-1.32) were significantly associated with a higher risk of developing any ICH compared to no ICH. Wake-up strokes (OR 3.99, 95% CI 1.38-11.60), transfer from an external clinic (OR 3.04, 95% CI 1.24-7.48), and higher serum glucose levels (OR 1.22 for change of 15 units mg/dL, 95% CI 1.05-1.42) were revealed as independent risk factors for development of symptomatic ICH compared to no symptomatic ICH. Patients with no infarct demarcation (OR 0.10, 95% CI 0.01-0.80) and complete recanalization (OR 0.57, 95% CI 0.37-0.86) showed a lower risk of developing any ICH. Conclusion Wake-up strokes and patients who are treated within a drip-and-ship concept are especially vulnerable for symptomatic ICH, while complete recanalization, contrary to subtotal recanalization only, was revealed as a protective factor against ICH.


Useful keywords (using NLM MeSH Indexing)

Aged

Brain Ischemia/diagnostic imaging

Brain Ischemia/surgery*

Cerebral Angiography/methods*

Computed Tomography Angiography/methods*

Female

Humans

Intracranial Hemorrhages/diagnostic imaging*

Intracranial Hemorrhages/etiology*

Magnetic Resonance Imaging/methods*

Male

Retrospective Studies

Risk Factors

Stroke/diagnostic imaging

Stroke/surgery*

Thrombectomy/adverse effects*

Treatment Outcome


Find related publications in this database (Keywords)

Ischemic stroke
Mechanical thrombectomy
Intracranial hemorrhage
Hemorrhagic transformation
Risk factors