Predictors of Symptomatic Intracranial Hemorrhage after Endovascular Thrombectomy in Acute Ischemic Stroke Patients with Anterior Large Vessel Occlusion-Procedure Time and Reperfusion Quality Determine

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). Data on stroke patients from January 2018 to December 2020 in a tertiary care centre were retrospectively analyse...

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Bibliographic Details
Published in:Journal of clinical medicine 2022-12, Vol.11 (24), p.7433
Main Authors: Li, Yan, van Landeghem, Natalie, Demircioglu, Aydin, Köhrmann, Martin, Dammann, Philipp, Oppong, Marvin Darkwah, Jabbarli, Ramazan, Theysohn, Jens Matthias, Altenbernd, Jens-Christian, Styczen, Hanna, Forsting, Michael, Wanke, Isabel, Frank, Benedikt, Deuschl, Cornelius
Format: Article
Language:English
Subjects:
Cardiovascular disease
Carotid arteries
Clinical medicine
General anesthesia
Hemorrhage
Mortality
Patients
Stroke
Variables
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Summary: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). 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. 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; = 0.004) and complete reperfusion (TICI 3) (OR 0.035; 95% CI 0.003-0.378; = 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, = 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, = 0.745) (OR 1.305; 95% CI 0.338-5.041, = 0.697). 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.
ISSN:2077-0383
2077-0383
DOI:10.3390/jcm11247433