Type of intracranial hemorrhage after endovascular stroke treatment: association with functional outcome.

Autor:	van der Steen W; Department of Neurology, Erasmus Medical Center, Rotterdam, The Netherlands w.vandersteen@erasmusmc.nl.; Department of Radiology and Nuclear Medicine, Erasmus Medical Center, Rotterdam, The Netherlands., van der Ende NAM; Department of Neurology, Erasmus Medical Center, Rotterdam, The Netherlands.; Department of Radiology and Nuclear Medicine, Erasmus Medical Center, Rotterdam, The Netherlands., Luijten SPR; Department of Radiology and Nuclear Medicine, Erasmus Medical Center, Rotterdam, The Netherlands., Rinkel LA; Department of Neurology, Amsterdam UMC Locatie AMC, Amsterdam, The Netherlands., van Kranendonk KR; Department of Radiology and Nuclear Medicine, Amsterdam UMC Locatie AMC, Amsterdam, The Netherlands., van Voorst H; Department of Radiology and Nuclear Medicine, Amsterdam UMC Locatie AMC, Amsterdam, The Netherlands.; Department of Biomedical Engineering and Physics, Amsterdam UMC Locatie AMC, Amsterdam, The Netherlands., Roosendaal SD; Department of Radiology and Nuclear Medicine, Amsterdam UMC Locatie AMC, Amsterdam, The Netherlands., Beenen LFM; Department of Radiology and Nuclear Medicine, Amsterdam UMC Locatie AMC, Amsterdam, The Netherlands., Coutinho JM; Department of Neurology, Amsterdam UMC Locatie AMC, Amsterdam, The Netherlands., Emmer BJ; Department of Radiology and Nuclear Medicine, Amsterdam UMC Locatie AMC, Amsterdam, The Netherlands., van Oostenbrugge RJ; Department of Neurology, Maastricht University Medical Centre+, Maastricht, The Netherlands., Majoie CBLM; Department of Radiology and Nuclear Medicine, Amsterdam UMC Locatie AMC, Amsterdam, The Netherlands., Lingsma HF; Department of Public Health, Erasmus Medical Center, Rotterdam, The Netherlands., van der Lugt A; Department of Radiology and Nuclear Medicine, Erasmus Medical Center, Rotterdam, The Netherlands., Dippel DWJ; Department of Neurology, Erasmus Medical Center, Rotterdam, The Netherlands., Roozenbeek B; Department of Neurology, Erasmus Medical Center, Rotterdam, The Netherlands.
Jazyk:	angličtina
Zdroj:	Journal of neurointerventional surgery [J Neurointerv Surg] 2023 Oct; Vol. 15 (10), pp. 971-976. Date of Electronic Publication: 2022 Oct 19.
DOI:	10.1136/jnis-2022-019474
Abstrakt:	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. Competing Interests: Competing interests: DWJD and AvdL report unrestricted grants from Stryker, Penumbra, Medtronic, Cerenovus, Thrombolytic Science, LLC, Dutch Heart Foundation, Brain Foundation Netherlands, The Netherlands Organization for Health Research and Development, Health Holland Top Sector Life Sciences & Health, and Thrombolytic Science, LLC for research, paid to the institution. BR reports funding from the Dutch Heart Foundation and the Netherlands Organisation of Health Research and Development, paid to the institution. BJE reports unrestricted grants from The Netherlands Organization for Health Research and Development, Health Holland Top Sector Life Sciences & Health, and Nicolab b.v. all paid to the institution. CM received funds from, CVON/Dutch Heart Foundation and Stryker, (related to this project, paid to institution) and from the European Commission, Healthcare Evaluation Netherlands TWIN Foundation (unrelated to this project; all paid to the institution) and is a shareholder of Nicolab. (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY. Published by BMJ.)
Databáze:	MEDLINE
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