Incidence, prognosis, and prediction of haemorrhagic transformation after revascularisation for stroke.

Autor:	García Jurado PB; Sección de Neurorradiología Diagnóstica y Terapéutica, UGC Radiodiagnóstico, Servicio de Neurología, Hospital Universitario Reina Sofía, Córdoba, España. Electronic address: pedroblasgj@gmail.com., Roldán Romero E; Sección de Neurorradiología Diagnóstica y Terapéutica, UGC Radiodiagnóstico, Servicio de Neurología, Hospital Universitario Reina Sofía, Córdoba, España., Pérez Montilla ME; Sección de Neurorradiología Diagnóstica y Terapéutica, UGC Radiodiagnóstico, Servicio de Neurología, Hospital Universitario Reina Sofía, Córdoba, España., Valverde Moyano R; Sección de Neurorradiología Diagnóstica y Terapéutica, UGC Radiodiagnóstico, Servicio de Neurología, Hospital Universitario Reina Sofía, Córdoba, España., Bravo Rey IM; Sección de Neurorradiología Diagnóstica y Terapéutica, UGC Radiodiagnóstico, Servicio de Neurología, Hospital Universitario Reina Sofía, Córdoba, España., Delgado Acosta F; Sección de Neurorradiología Diagnóstica y Terapéutica, UGC Radiodiagnóstico, Servicio de Neurología, Hospital Universitario Reina Sofía, Córdoba, España., Bravo-Rodríguez FA; Sección de Neurorradiología Diagnóstica y Terapéutica, UGC Radiodiagnóstico, Servicio de Neurología, Hospital Universitario Reina Sofía, Córdoba, España.
Jazyk:	English; Spanish; Castilian
Zdroj:	Neurologia [Neurologia (Engl Ed)] 2018 Jun 11. Date of Electronic Publication: 2018 Jun 11.
DOI:	10.1016/j.nrl.2018.04.002
Abstrakt:	Introduction: Haemorrhagic transformation is a major complication of acute ischaemic stroke (AIS). We sought to determine the predictors and clinical impact of intracranial haemorrhage (ICH) after revascularisation therapy. Methods: We conducted a retrospective, single-centre study including 235 patients with AIS who underwent intravenous recombinant tissue plasminogen activator (IV-rtPA) therapy and/or endovascular treatment. A binary logistic regression model was used to determine the variables associated with ICH, parenchymal haematomas (PH), modified Rankin Scale (mRS) scores, and mortality. Results: ICH was detected in 57 (30 with PH) of 183 patients included. Mechanical thrombectomy, either alone (OR 3.3 [1.42-7.63], P=.005) or in combination with IV-rtPA (OR 3.39 [1,52-7.56], P=.003), was associated with higher risk of ICH, while higher Alberta Stroke Program Early CT scores (OR 0.71 [0.55-0.91], P=.007) were associated with lower risk. Patients with older age (OR 1.07 [1.02-1.13], P=.006) and occlusion of the terminal branch of the internal carotid artery (OR 4.03 [1.35-11.99], P = .012) had a higher risk of PH, while the use of IV-rtPA alone (OR 0.24 [0.08-0.68], P=.008) was associated with lower risk of PH. Only PH was associated with disability as measured by the mRS (OR 3.2 [1.17-8.76], P=.02) and higher mortality (OR 5.06 [1.65-15.5], P=.005). Conclusions: Greater understanding about the predictors of ICH, mRS scores, and mortality could enable better selection of patients and treatments. (Copyright © 2018 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.)
Databáze:	MEDLINE
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