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Predictors of symptomatic intracerebral hemorrhage after endovascular treatment for acute ischemic stroke due to tandem lesion in anterior circulation
R. Havlíček, D. Šaňák, D. Černík, J. Neradová, N. Leško, Z. Gdovinová, M. Köcher, F. Cihlář, J. Malik, J. Fedorko, P. Pedowski, J. Zapletalová
Language English Country United States
Document type Journal Article, Multicenter Study
- MeSH
- Time Factors MeSH
- Cerebral Hemorrhage * diagnostic imaging etiology therapy MeSH
- Dual Anti-Platelet Therapy adverse effects MeSH
- Endovascular Procedures * adverse effects instrumentation MeSH
- Fibrinolytic Agents * administration & dosage adverse effects MeSH
- Risk Assessment MeSH
- Platelet Aggregation Inhibitors * adverse effects administration & dosage MeSH
- Ischemic Stroke * etiology therapy diagnosis diagnostic imaging MeSH
- Middle Aged MeSH
- Humans MeSH
- Disability Evaluation * MeSH
- Retrospective Studies MeSH
- Risk Factors MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Stents MeSH
- Treatment Outcome MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Multicenter Study MeSH
- Geographicals
- Japan MeSH
BACKGROUND: Endovascular treatment (EVT) of tandem lesion (TL) in the anterior circulation acute ischemic stroke (IS) usually requires periprocedural antithrombotic treatment and early initiation of dual antiplatelet therapy (DAPT) after carotid stenting. However, it may contribute to an occurrence of symptomatic intracerebral hemorrhage (SICH) in some cases. We investigated factors influencing the SICH occurrence and assessed the possible predictors of SICH after EVT. METHODS: IS patients with TL in the anterior circulation treated with EVT were enrolled in the multicenter retrospective ASCENT study. A good three-month clinical outcome was scored as 0-2 points in modified Rankin Scale (mRS) and recanalization using the TICI scale. SICH was assessed using the SITS-MOST criteria. Logistic regression analysis was used for the assessment of possible predictors of SICH with adjustment for potential confounders. RESULTS: In total, 300 (68.7 % males, mean age 67.3 ± 10.2 years) patients with median of admission NIHSS 17 were analyzed. Recanalization (TICI 2b-3) was achieved in 290 (96.7 %) patients and 176 (58.7 %) had mRS 0-2. SICH occurred in 25 (8.3 %) patients. Patients with SICH did not differ from those without SICH in the rate of periprocedural antithrombotic treatment (64 vs. 57.5 %, p = 0.526) and in the rate of DAPT started within the first 12 h after EVT (20 vs. 42.2 %, p = 0.087). After adjustment, admission NIHSS and admission glycemia were found as the only predictors of SICH after EVT. CONCLUSION: Admission NIHSS and glycemia were found as the only predictors of SICH after EVT for TL. No associations between periprocedural antithrombotic treatment, early start of DAPT after EVT and SICH occurrence were found.
Comprehensive Stroke Center Department of Neurology Central Military Hospital Prague Czech Republic
Department of Biophysics and Statistics Palacký University Medical School Olomouc Czech Republic
Department of Radiology Central Military Hospital Prague Czech Republic
References provided by Crossref.org
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