Detail
Článek
Článek online
FT
Medvik - BMČ
  • Je něco špatně v tomto záznamu ?

Intracerebral hemorrhage risk after adjunct intraarterial thrombolysis in thrombectomy-treated acute ischemic stroke

AI. Qureshi, Y. Huang, IA. Bhatti, CR. Gomez, DF. Hanley, DE. Ford, AE. Hassan, TN. Nguyen, AM. Spiotta, E. Veznedaroglu, RF. Budzik, R. Gupta, RG. Nogueira, A. Krajina, B. Bartolini, J. English, B. Baxter, DS. Liebeskind

. 2024 ; 34 (6) : 773-780. [pub] 20240922

Jazyk angličtina Země Spojené státy americké

Typ dokumentu časopisecké články, multicentrická studie

Perzistentní odkaz   https://www.medvik.cz/link/bmc25003635

Grantová podpora
Stryker Neurovascular

BACKGROUND AND PURPOSE: Intraarterial thrombolysis as an adjunct to mechanical thrombectomy is increasingly being considered to enhance reperfusion in acute ischemic stroke patients. Intraarterial thrombolysis may increase the risk of post-thrombectomy intracerebral hemorrhage (ICH) in certain patient subgroups. METHODS: We analyzed acute ischemic stroke patients treated with mechanical thrombectomy in a multicenter registry. The occurrence of any (asymptomatic and symptomatic) post-thrombectomy ICH was ascertained using standard definition requiring serial neurological examinations and computed tomographic scans acquired within 48 hours of the thrombectomy. We determined the risk of ICH in subgroups defined by clinical characteristics and the use of intravenous (IV) thrombolysis. RESULTS: A total of 146 (7.5%) patients received intraarterial thrombolysis among 1953 acute ischemic stroke patients who underwent mechanical thrombectomy. The proportion of patients who developed any ICH was 26 (17.8%) and 510 (28.2%) among patients who were and were not treated with intraarterial thrombolysis, respectively (p = .006). The proportion of patients who developed symptomatic ICH was 4 (2.7%) and 30 (1.7%) among patients who were and were not treated with intraarterial thrombolysis, respectively (p = .34). Among patients who received IV thrombolysis (n = 1042), the proportion of patients who developed any ICH was 9 (16.7%) and 294 (30.7%) among patients who were and were not treated with intraarterial thrombolysis, respectively (p = .028). The risk was not different in strata defined by age, gender, location of occlusion, preprocedure National Institutes of Health Stroke Scale score, time interval between symptom onset and thrombectomy, Alberta Stroke Program Early CT Score, systolic blood pressure, and serum glucose concentrations. CONCLUSIONS: In patients undergoing mechanical thrombectomy, the risk of any ICH and symptomatic ICH was not increased with intraarterial thrombolysis, including in those who had already received IV thrombolytics.

Citace poskytuje Crossref.org

000      
00000naa a2200000 a 4500
001      
bmc25003635
003      
CZ-PrNML
005      
20250206104454.0
007      
ta
008      
250121s2024 xxu f 000 0|eng||
009      
AR
024    7_
$a 10.1111/jon.13238 $2 doi
035    __
$a (PubMed)39307964
040    __
$a ABA008 $b cze $d ABA008 $e AACR2
041    0_
$a eng
044    __
$a xxu
100    1_
$a Qureshi, Adnan I $u Zeenat Qureshi Stroke Institutes, St Cloud, Minnesota, USA $u Department of Neurology, University of Missouri, Columbia, Missouri, USA $1 https://orcid.org/000000034962540X
245    10
$a Intracerebral hemorrhage risk after adjunct intraarterial thrombolysis in thrombectomy-treated acute ischemic stroke / $c AI. Qureshi, Y. Huang, IA. Bhatti, CR. Gomez, DF. Hanley, DE. Ford, AE. Hassan, TN. Nguyen, AM. Spiotta, E. Veznedaroglu, RF. Budzik, R. Gupta, RG. Nogueira, A. Krajina, B. Bartolini, J. English, B. Baxter, DS. Liebeskind
520    9_
$a BACKGROUND AND PURPOSE: Intraarterial thrombolysis as an adjunct to mechanical thrombectomy is increasingly being considered to enhance reperfusion in acute ischemic stroke patients. Intraarterial thrombolysis may increase the risk of post-thrombectomy intracerebral hemorrhage (ICH) in certain patient subgroups. METHODS: We analyzed acute ischemic stroke patients treated with mechanical thrombectomy in a multicenter registry. The occurrence of any (asymptomatic and symptomatic) post-thrombectomy ICH was ascertained using standard definition requiring serial neurological examinations and computed tomographic scans acquired within 48 hours of the thrombectomy. We determined the risk of ICH in subgroups defined by clinical characteristics and the use of intravenous (IV) thrombolysis. RESULTS: A total of 146 (7.5%) patients received intraarterial thrombolysis among 1953 acute ischemic stroke patients who underwent mechanical thrombectomy. The proportion of patients who developed any ICH was 26 (17.8%) and 510 (28.2%) among patients who were and were not treated with intraarterial thrombolysis, respectively (p = .006). The proportion of patients who developed symptomatic ICH was 4 (2.7%) and 30 (1.7%) among patients who were and were not treated with intraarterial thrombolysis, respectively (p = .34). Among patients who received IV thrombolysis (n = 1042), the proportion of patients who developed any ICH was 9 (16.7%) and 294 (30.7%) among patients who were and were not treated with intraarterial thrombolysis, respectively (p = .028). The risk was not different in strata defined by age, gender, location of occlusion, preprocedure National Institutes of Health Stroke Scale score, time interval between symptom onset and thrombectomy, Alberta Stroke Program Early CT Score, systolic blood pressure, and serum glucose concentrations. CONCLUSIONS: In patients undergoing mechanical thrombectomy, the risk of any ICH and symptomatic ICH was not increased with intraarterial thrombolysis, including in those who had already received IV thrombolytics.
650    _2
$a lidé $7 D006801
650    _2
$a mužské pohlaví $7 D008297
650    _2
$a ženské pohlaví $7 D005260
650    _2
$a senioři $7 D000368
650    12
$a trombolytická terapie $x škodlivé účinky $7 D015912
650    12
$a cerebrální krvácení $x diagnostické zobrazování $7 D002543
650    12
$a ischemická cévní mozková příhoda $x diagnostické zobrazování $x chirurgie $7 D000083242
650    12
$a trombektomie $x metody $7 D017131
650    12
$a fibrinolytika $x aplikace a dávkování $x škodlivé účinky $7 D005343
650    _2
$a lidé středního věku $7 D008875
650    _2
$a výsledek terapie $7 D016896
650    _2
$a registrace $7 D012042
650    _2
$a kombinovaná terapie $7 D003131
650    _2
$a rizikové faktory $7 D012307
650    _2
$a senioři nad 80 let $7 D000369
655    _2
$a časopisecké články $7 D016428
655    _2
$a multicentrická studie $7 D016448
700    1_
$a Huang, Yilun $u Zeenat Qureshi Stroke Institutes, St Cloud, Minnesota, USA
700    1_
$a Bhatti, Ibrahim A $u Zeenat Qureshi Stroke Institutes, St Cloud, Minnesota, USA $u Department of Neurology, University of Missouri, Columbia, Missouri, USA $1 https://orcid.org/0009000385795593
700    1_
$a Gomez, Camilo R $u Department of Neurology, University of Missouri, Columbia, Missouri, USA $1 https://orcid.org/0000000280025157
700    1_
$a Hanley, Daniel F $u Department of Neurology, Johns Hopkins University, Baltimore, Maryland, USA
700    1_
$a Ford, Daniel E $u Department of Internal Medicine, Johns Hopkins University, Baltimore, Maryland, USA
700    1_
$a Hassan, Ameer E $u Department of Neurology, Valley Baptist Medical Center Harlingen, Harlingen, Texas, USA $1 https://orcid.org/0000000271487616
700    1_
$a Nguyen, Thanh N $u Department of Neurology, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
700    1_
$a Spiotta, Alejandro M $u Department of Neurosurgery, Medical University of South Carolina, Charleston, South Carolina, USA
700    1_
$a Veznedaroglu, Erol $u Department of Neurosurgery, Drexel University College of Medicine, Philadelphia, Pennsylvania, USA
700    1_
$a Budzik, Ronald F $u Department of Neuroradiology, Riverside Methodist Hospital, Columbus, Ohio, USA
700    1_
$a Gupta, Rishi $u Department of Neurology, Wellstar Health System, Marietta, Georgia, USA
700    1_
$a Nogueira, Raul G $u Department of Neurology, University of Pittsburgh Medical Center Stroke Institute, Pittsburgh, Pennsylvania, USA $1 https://orcid.org/0000000308769167 $7 nlk20050172885
700    1_
$a Krajina, Antonin $u Department of Radiology, Charles University, Hradec Králové, Czech Republic
700    1_
$a Bartolini, Bruno $u Diagnostic and Interventional Radiology, Lausanne University Hospital, Lausanne, Switzerland
700    1_
$a English, Joey $u Department of Neurology, Sutter California Pacific Medical Center, San Francisco, California, USA
700    1_
$a Baxter, Blaise $u Department of Radiology, Lehigh Valley Health Network, Allentown, Pennsylvania, USA
700    1_
$a Liebeskind, David S $u Department of Neurology, UCLA Health, Los Angeles, California, USA $1 https://orcid.org/0000000251098736
773    0_
$w MED00002833 $t Journal of neuroimaging $x 1552-6569 $g Roč. 34, č. 6 (2024), s. 773-780
856    41
$u https://pubmed.ncbi.nlm.nih.gov/39307964 $y Pubmed
910    __
$a ABA008 $b sig $c sign $y - $z 0
990    __
$a 20250121 $b ABA008
991    __
$a 20250206104450 $b ABA008
999    __
$a ok $b bmc $g 2263407 $s 1239642
BAS    __
$a 3
BAS    __
$a PreBMC-MEDLINE
BMC    __
$a 2024 $b 34 $c 6 $d 773-780 $e 20240922 $i 1552-6569 $m Journal of neuroimaging $n J Neuroimaging $x MED00002833
GRA    __
$p Stryker Neurovascular
LZP    __
$a Pubmed-20250121

Najít záznam

Citační ukazatele

Pouze přihlášení uživatelé

Možnosti archivace