Determinants of Symptomatic Intracranial Hemorrhage After Endovascular Stroke Treatment : A Retrospective Cohort Study
BACKGROUND: Symptomatic intracranial hemorrhage (sICH) is a serious complication after endovascular treatment for ischemic stroke. We aimed to identify determinants of its occurrence and location.
METHODS: We retrospectively analyzed data from the Dutch MR CLEAN trial (Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands) and MR CLEAN registry. We included adult patients with a large vessel occlusion in the anterior circulation who underwent endovascular treatment within 6.5 hours of stroke onset. We used univariable and multivariable logistic regression analyses to identify determinants of overall sICH occurrence, sICH within infarcted brain tissue, and sICH outside infarcted brain tissue.
RESULTS: SICH occurred in 203 (6%) of 3313 included patients and was located within infarcted brain tissue in 50 (25%), outside infarcted brain tissue in 23 (11%), and both within and outside infarcted brain tissue in 116 (57%) patients. In 14 patients (7%), data on location were missing. Prior antiplatelet use, baseline systolic blood pressure, baseline plasma glucose levels, post-endovascular treatment modified treatment in cerebral ischemia score, and duration of procedure were associated with all outcome parameters. In addition, determinants of sICH within infarcted brain tissue included history of myocardial infarction (adjusted odds ratio, 1.65 [95% CI, 1.06-2.56]) and poor collateral score (adjusted odds ratio, 1.42 [95% CI, 1.02-1.95]), whereas determinants of sICH outside infarcted brain tissue included level of occlusion on computed tomography angiography (internal carotid artery or internal carotid artery terminus compared with M1: adjusted odds ratio, 1.79 [95% CI, 1.16-2.78]).
CONCLUSIONS: Several factors, some potentially modifiable, are associated with sICH occurrence. Further studies should investigate whether modification of baseline systolic blood pressure or plasma glucose level could reduce the risk of sICH. In addition, determinants differ per location of sICH, supporting the hypothesis of varying underlying mechanisms.
REGISTRATION: URL: https://www.isrctn.com/; Unique identifier: ISRCTN10888758.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:53 |
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| Enthalten in: |
Stroke - 53(2022), 9 vom: 01. Sept., Seite 2818-2827 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
van der Steen, Wouter [VerfasserIn] |
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| Links: |
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| Themen: |
Adult |
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| Anmerkungen: |
Date Completed 24.08.2022 Date Revised 06.09.2022 published: Print-Electronic ISRCTN: ISRCTN10888758 Citation Status MEDLINE |
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| doi: |
10.1161/STROKEAHA.121.036195 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM341958468 |
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| 041 | |a eng | ||
| 100 | 1 | |a van der Steen, Wouter |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Determinants of Symptomatic Intracranial Hemorrhage After Endovascular Stroke Treatment |b A Retrospective Cohort Study |
| 264 | 1 | |c 2022 | |
| 336 | |a Text |b txt |2 rdacontent | ||
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| 500 | |a Date Completed 24.08.2022 | ||
| 500 | |a Date Revised 06.09.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a ISRCTN: ISRCTN10888758 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a BACKGROUND: Symptomatic intracranial hemorrhage (sICH) is a serious complication after endovascular treatment for ischemic stroke. We aimed to identify determinants of its occurrence and location | ||
| 520 | |a METHODS: We retrospectively analyzed data from the Dutch MR CLEAN trial (Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands) and MR CLEAN registry. We included adult patients with a large vessel occlusion in the anterior circulation who underwent endovascular treatment within 6.5 hours of stroke onset. We used univariable and multivariable logistic regression analyses to identify determinants of overall sICH occurrence, sICH within infarcted brain tissue, and sICH outside infarcted brain tissue | ||
| 520 | |a RESULTS: SICH occurred in 203 (6%) of 3313 included patients and was located within infarcted brain tissue in 50 (25%), outside infarcted brain tissue in 23 (11%), and both within and outside infarcted brain tissue in 116 (57%) patients. In 14 patients (7%), data on location were missing. Prior antiplatelet use, baseline systolic blood pressure, baseline plasma glucose levels, post-endovascular treatment modified treatment in cerebral ischemia score, and duration of procedure were associated with all outcome parameters. In addition, determinants of sICH within infarcted brain tissue included history of myocardial infarction (adjusted odds ratio, 1.65 [95% CI, 1.06-2.56]) and poor collateral score (adjusted odds ratio, 1.42 [95% CI, 1.02-1.95]), whereas determinants of sICH outside infarcted brain tissue included level of occlusion on computed tomography angiography (internal carotid artery or internal carotid artery terminus compared with M1: adjusted odds ratio, 1.79 [95% CI, 1.16-2.78]) | ||
| 520 | |a CONCLUSIONS: Several factors, some potentially modifiable, are associated with sICH occurrence. Further studies should investigate whether modification of baseline systolic blood pressure or plasma glucose level could reduce the risk of sICH. In addition, determinants differ per location of sICH, supporting the hypothesis of varying underlying mechanisms | ||
| 520 | |a REGISTRATION: URL: https://www.isrctn.com/; Unique identifier: ISRCTN10888758 | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Multicenter Study | |
| 650 | 4 | |a Randomized Controlled Trial | |
| 650 | 4 | |a adult | |
| 650 | 4 | |a blood glucose | |
| 650 | 4 | |a brain ischemia | |
| 650 | 4 | |a humans | |
| 650 | 4 | |a intracranial hemorrhages | |
| 650 | 4 | |a retrospective studies | |
| 650 | 7 | |a Blood Glucose |2 NLM | |
| 700 | 1 | |a van der Ende, Nadinda A M |e verfasserin |4 aut | |
| 700 | 1 | |a van Kranendonk, Katinka R |e verfasserin |4 aut | |
| 700 | 1 | |a Chalos, Vicky |e verfasserin |4 aut | |
| 700 | 1 | |a van Oostenbrugge, Robert J |e verfasserin |4 aut | |
| 700 | 1 | |a van Zwam, Wim H |e verfasserin |4 aut | |
| 700 | 1 | |a Roos, Yvo B W E M |e verfasserin |4 aut | |
| 700 | 1 | |a van Doormaal, Pieter J |e verfasserin |4 aut | |
| 700 | 1 | |a van Es, Adriaan C G M |e verfasserin |4 aut | |
| 700 | 1 | |a Lingsma, Hester F |e verfasserin |4 aut | |
| 700 | 1 | |a Majoie, Charles B L M |e verfasserin |4 aut | |
| 700 | 1 | |a van der Lugt, Aad |e verfasserin |4 aut | |
| 700 | 1 | |a Dippel, Diederik W J |e verfasserin |4 aut | |
| 700 | 1 | |a Roozenbeek, Bob |e verfasserin |4 aut | |
| 700 | 0 | |a MR CLEAN Trial and MR CLEAN Registry Investigators |e verfasserin |4 aut | |
| 700 | 1 | |a Boiten, Jelis |e investigator |4 oth | |
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| 700 | 1 | |a Mulder, Maxim J H L |e investigator |4 oth | |
| 700 | 1 | |a Goldhoorn, Robert-Jan B |e investigator |4 oth | |
| 700 | 1 | |a Compagne, Kars C J |e investigator |4 oth | |
| 700 | 1 | |a Kappelhof, Manon |e investigator |4 oth | |
| 700 | 1 | |a Brouwer, Josje |e investigator |4 oth | |
| 700 | 1 | |a den Hartog, Sanne J |e investigator |4 oth | |
| 700 | 1 | |a Emmer, Bart J |e investigator |4 oth | |
| 700 | 1 | |a Coutinho, Jonathan M |e investigator |4 oth | |
| 700 | 1 | |a Schonewille, Wouter J |e investigator |4 oth | |
| 700 | 1 | |a Albert Vos, Jan |e investigator |4 oth | |
| 700 | 1 | |a Wermer, Marieke J H |e investigator |4 oth | |
| 700 | 1 | |a van Walderveen, Marianne A A |e investigator |4 oth | |
| 700 | 1 | |a Staals, Julie |e investigator |4 oth | |
| 700 | 1 | |a Hofmeijer, Jeannette |e investigator |4 oth | |
| 700 | 1 | |a Martens, Jasper M |e investigator |4 oth | |
| 700 | 1 | |a Lycklama À Nijeholt, Geert J |e investigator |4 oth | |
| 700 | 1 | |a Boiten, Jelis |e investigator |4 oth | |
| 700 | 1 | |a de Bruijn, Sebastiaan F |e investigator |4 oth | |
| 700 | 1 | |a van Dijk, Lukas C |e investigator |4 oth | |
| 700 | 1 | |a van der Worp, H Bart |e investigator |4 oth | |
| 700 | 1 | |a Lo, Rob H |e investigator |4 oth | |
| 700 | 1 | |a van Dijk, Ewoud J |e investigator |4 oth | |
| 700 | 1 | |a Boogaarts, Hieronymus D |e investigator |4 oth | |
| 700 | 1 | |a de Vries, J |e investigator |4 oth | |
| 700 | 1 | |a de Kort, Paul L M |e investigator |4 oth | |
| 700 | 1 | |a van Tuijl, Julia |e investigator |4 oth | |
| 700 | 1 | |a Peluso, Jo P |e investigator |4 oth | |
| 700 | 1 | |a Fransen, Puck |e investigator |4 oth | |
| 700 | 1 | |a van den Berg, Jan S P |e investigator |4 oth | |
| 700 | 1 | |a van Hasselt, Boudewijn A A M |e investigator |4 oth | |
| 700 | 1 | |a Aerden, Leo A M |e investigator |4 oth | |
| 700 | 1 | |a Dallinga, René J |e investigator |4 oth | |
| 700 | 1 | |a Uyttenboogaart, Maarten |e investigator |4 oth | |
| 700 | 1 | |a Eschgi, Omid |e investigator |4 oth | |
| 700 | 1 | |a Bokkers, Reinoud P H |e investigator |4 oth | |
| 700 | 1 | |a Schreuder, Tobien H C M L |e investigator |4 oth | |
| 700 | 1 | |a Heijboer, Roel J J |e investigator |4 oth | |
| 700 | 1 | |a Keizer, Koos |e investigator |4 oth | |
| 700 | 1 | |a Yo, Lonneke S F |e investigator |4 oth | |
| 700 | 1 | |a den Hertog, Heleen M |e investigator |4 oth | |
| 700 | 1 | |a Bulut, Tomas |e investigator |4 oth | |
| 700 | 1 | |a Brouwers, Paul J A M |e investigator |4 oth | |
| 700 | 1 | |a Lycklama, Geert J |e investigator |4 oth | |
| 700 | 1 | |a van Walderveen, Marianne A A |e investigator |4 oth | |
| 700 | 1 | |a Sprengers, Marieke E S |e investigator |4 oth | |
| 700 | 1 | |a Jenniskens, Sjoerd F M |e investigator |4 oth | |
| 700 | 1 | |a van den Berg, René |e investigator |4 oth | |
| 700 | 1 | |a Yoo, Albert J |e investigator |4 oth | |
| 700 | 1 | |a Beenen, Ludo F M |e investigator |4 oth | |
| 700 | 1 | |a Postma, Alida A |e investigator |4 oth | |
| 700 | 1 | |a Roosendaal, Stefan D |e investigator |4 oth | |
| 700 | 1 | |a van der Kallen, Bas F W |e investigator |4 oth | |
| 700 | 1 | |a van den Wijngaard, Ido R |e investigator |4 oth | |
| 700 | 1 | |a Emmer, Bart J |e investigator |4 oth | |
| 700 | 1 | |a Martens, Jasper M |e investigator |4 oth | |
| 700 | 1 | |a Yo, Lonneke S F |e investigator |4 oth | |
| 700 | 1 | |a Vos, Jan Albert |e investigator |4 oth | |
| 700 | 1 | |a Bot, Joost |e investigator |4 oth | |
| 700 | 1 | |a Meijer, Anton |e investigator |4 oth | |
| 700 | 1 | |a Ghariq, Elyas |e investigator |4 oth | |
| 700 | 1 | |a Bokkers, Reinoud P H |e investigator |4 oth | |
| 700 | 1 | |a van Proosdij, Marc P |e investigator |4 oth | |
| 700 | 1 | |a Krietemeijer, G Menno |e investigator |4 oth | |
| 700 | 1 | |a Peluso, Jo P |e investigator |4 oth | |
| 700 | 1 | |a Boogaarts, Hieronymus D |e investigator |4 oth | |
| 700 | 1 | |a Lo, Rob |e investigator |4 oth | |
| 700 | 1 | |a Dinkelaar, Wouter |e investigator |4 oth | |
| 700 | 1 | |a Auke, P A |e investigator |4 oth | |
| 700 | 1 | |a Hammer, Bas |e investigator |4 oth | |
| 700 | 1 | |a Pegge, Sjoert |e investigator |4 oth | |
| 700 | 1 | |a van der Hoorn, Anouk |e investigator |4 oth | |
| 700 | 1 | |a Vinke, Saman |e investigator |4 oth | |
| 700 | 1 | |a Lycklama À Nijeholt, Geert J |e investigator |4 oth | |
| 700 | 1 | |a Boiten, Jelis |e investigator |4 oth | |
| 700 | 1 | |a Vos, Jan Albert |e investigator |4 oth | |
| 700 | 1 | |a Hofmeijer, Jeannette |e investigator |4 oth | |
| 700 | 1 | |a Martens, Jasper M |e investigator |4 oth | |
| 700 | 1 | |a van der Worp, H Bart |e investigator |4 oth | |
| 700 | 1 | |a Hofmeijer, Jeannette |e investigator |4 oth | |
| 700 | 1 | |a Flach, H Zwenneke |e investigator |4 oth | |
| 700 | 1 | |a El Ghannouti, Naziha |e investigator |4 oth | |
| 700 | 1 | |a Sterrenberg, Martin |e investigator |4 oth | |
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| 700 | 1 | |a Sprengers, Rita |e investigator |4 oth | |
| 700 | 1 | |a Elfrink, Marjan |e investigator |4 oth | |
| 700 | 1 | |a Simons, Michelle |e investigator |4 oth | |
| 700 | 1 | |a Vossers, Marjolein |e investigator |4 oth | |
| 700 | 1 | |a de Meris, Joke |e investigator |4 oth | |
| 700 | 1 | |a Vermeulen, Tamara |e investigator |4 oth | |
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| 700 | 1 | |a Bodde, Karin |e investigator |4 oth | |
| 700 | 1 | |a Kleijn, Sandra |e investigator |4 oth | |
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