Type of intracranial hemorrhage after endovascular stroke treatment : association with functional outcome
© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY. Published by BMJ..
BACKGROUND: Intracranial hemorrhage (ICH) is a frequent complication after endovascular stroke treatment.
OBJECTIVE: To assess the association of the occurrence and type of ICH after endovascular treatment (EVT) with functional outcome.
METHODS: We analyzed data from the MR CLEAN-NO IV and MR CLEAN-MED trials. Both trials included adult patients with ischemic stroke with a large vessel occlusion in the anterior circulation, who were eligible for EVT. ICH was classified (1) as asymptomatic or symptomatic (concomitant neurological deterioration of ≥4 points on the NIHSS, or ≥2 points on 1 NIHSS item), and (2) according to the Heidelberg Bleeding Classification. We used multivariable ordinal logistic regression analyses to assess the association of the occurrence and type of ICH with the modified Rankin Scale score at 90 days.
RESULTS: Of 1017 included patients, 331 (33%) had an asymptomatic ICH, and 90 (9%) had a symptomatic ICH. Compared with no ICH, both asymptomatic (adjusted common OR (acOR)=0.76; 95% CI 0.58 to 0.98) and symptomatic (acOR=0.07; 95% CI 0.04 to 0.14) ICH were associated with worse functional outcome. In particular, isolated parenchymal hematoma type 2 (acOR=0.37; 95% CI 0.14 to 0.95), combined parenchymal hematoma with hemorrhage outside infarcted brain tissue (acOR=0.17; 95% CI 0.10 to 0.30), and combined hemorrhages outside infarcted brain tissue (acOR=0.14; 95% CI 0.03 to 0.74) were associated with worse functional outcome than no ICH.Strength of the association of ICH with functional outcome depends on the type of ICH. Although the association is stronger for symptomatic ICH, asymptomatic ICH after EVT is also associated with worse functional outcome.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:15 |
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| Enthalten in: |
Journal of neurointerventional surgery - 15(2023), 10 vom: 19. Okt., Seite 971-976 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
van der Steen, Wouter [VerfasserIn] |
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| Anmerkungen: |
Date Completed 18.09.2023 Date Revised 23.09.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1136/jnis-2022-019474 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM347759769 |
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| 100 | 1 | |a van der Steen, Wouter |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Type of intracranial hemorrhage after endovascular stroke treatment |b association with functional outcome |
| 264 | 1 | |c 2023 | |
| 336 | |a Text |b txt |2 rdacontent | ||
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| 500 | |a Date Completed 18.09.2023 | ||
| 500 | |a Date Revised 23.09.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY. Published by BMJ. | ||
| 520 | |a BACKGROUND: Intracranial hemorrhage (ICH) is a frequent complication after endovascular stroke treatment | ||
| 520 | |a OBJECTIVE: To assess the association of the occurrence and type of ICH after endovascular treatment (EVT) with functional outcome | ||
| 520 | |a METHODS: We analyzed data from the MR CLEAN-NO IV and MR CLEAN-MED trials. Both trials included adult patients with ischemic stroke with a large vessel occlusion in the anterior circulation, who were eligible for EVT. ICH was classified (1) as asymptomatic or symptomatic (concomitant neurological deterioration of ≥4 points on the NIHSS, or ≥2 points on 1 NIHSS item), and (2) according to the Heidelberg Bleeding Classification. We used multivariable ordinal logistic regression analyses to assess the association of the occurrence and type of ICH with the modified Rankin Scale score at 90 days | ||
| 520 | |a RESULTS: Of 1017 included patients, 331 (33%) had an asymptomatic ICH, and 90 (9%) had a symptomatic ICH. Compared with no ICH, both asymptomatic (adjusted common OR (acOR)=0.76; 95% CI 0.58 to 0.98) and symptomatic (acOR=0.07; 95% CI 0.04 to 0.14) ICH were associated with worse functional outcome. In particular, isolated parenchymal hematoma type 2 (acOR=0.37; 95% CI 0.14 to 0.95), combined parenchymal hematoma with hemorrhage outside infarcted brain tissue (acOR=0.17; 95% CI 0.10 to 0.30), and combined hemorrhages outside infarcted brain tissue (acOR=0.14; 95% CI 0.03 to 0.74) were associated with worse functional outcome than no ICH.Strength of the association of ICH with functional outcome depends on the type of ICH. Although the association is stronger for symptomatic ICH, asymptomatic ICH after EVT is also associated with worse functional outcome | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Complication | |
| 650 | 4 | |a Hemorrhage | |
| 650 | 4 | |a Stroke | |
| 650 | 4 | |a Thrombectomy | |
| 700 | 1 | |a van der Ende, Nadinda A M |e verfasserin |4 aut | |
| 700 | 1 | |a Luijten, Sven P R |e verfasserin |4 aut | |
| 700 | 1 | |a Rinkel, Leon A |e verfasserin |4 aut | |
| 700 | 1 | |a van Kranendonk, Katinka R |e verfasserin |4 aut | |
| 700 | 1 | |a van Voorst, Henk |e verfasserin |4 aut | |
| 700 | 1 | |a Roosendaal, Stefan D |e verfasserin |4 aut | |
| 700 | 1 | |a Beenen, Ludo F M |e verfasserin |4 aut | |
| 700 | 1 | |a Coutinho, Jonathan M |e verfasserin |4 aut | |
| 700 | 1 | |a Emmer, Bart J |e verfasserin |4 aut | |
| 700 | 1 | |a van Oostenbrugge, Robert J |e verfasserin |4 aut | |
| 700 | 1 | |a Majoie, Charles B L M |e verfasserin |4 aut | |
| 700 | 1 | |a Lingsma, Hester F |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-NO IV, MR CLEAN-MED, and CONTRAST investigators |e verfasserin |4 aut | |
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