Risk factors and predictors of intracranial hemorrhage after mechanical thrombectomy in acute ischemic stroke: insights from the Stroke Thrombectomy and Aneurysm Registry (STAR)

Autor: Natasha Ironside, Ching-Jen Chen, Reda M Chalhoub, Ryan T Kellogg, Dale Ding, Ilko Maier, Sami Al Kasab, Pascal Jabbour, Joon-tae Kim, Stacey Q Wolfe, Ansaar Rai, Robert M Starke, Marios-Nikos Psychogios, Amir Shaban, Adam S Arthur, Shinichi Yoshimura, Jonathan A Grossberg, Ali Alawieh, Isabel Fragata, Adam J Polifka, Justin R Mascitelli, Joshua W Osbun, Charles Matouk, Michael R Levitt, Travis M Dumont, Hugo H Cuellar-Saenz, Richard Williamson, Daniele G Romano, Roberto Javier Crosa, Benjamin Gory, Maxim Mokin, Mark Moss, Kaustubh Limaye, Peter Kan, Alejandro M Spiotta, Min S Park
Rok vydání: 2023
Předmět:
Zdroj: Journal of NeuroInterventional Surgery. :jnis-2022
ISSN: 1759-8486
1759-8478
Popis: BackgroundReducing intracranial hemorrhage (ICH) can improve patient outcome in acute ischemic stroke (AIS) intervention. We sought to identify ICH risk factors after AIS thrombectomy.MethodsThis is a retrospective review of the Stroke Thrombectomy and Aneurysm Registry (STAR) database. All patients who underwent AIS thrombectomy with available ICH data were included. Multivariable regression models were developed to identify predictors of ICH after thrombectomy. Subgroup analyses were performed stratified by symptom status and European Cooperative Acute Stroke Study (ECASS) grade.ResultsThe study cohort comprised 6860 patients. Any ICH and symptomatic ICH (sICH) occurred in 25% and 7% of patients, respectively. Hemorrhagic infarction 1 (HI1) occurred in 36%, HI2 in 24%, parenchymal hemorrhage 1 (PH1) in 22%, and PH2 in 17% of patients classified by ECASS grade. Intraprocedural complications independently predicted any ICH (OR 3.8083, PConclusionsThis study identified ICH risk factors after AIS thrombectomy using real-world data. There was a propensity towards a reduced sICH risk with direct aspiration. Procedural complications and ethnicity were predictors congruent between categories of any ICH, sICH, PH1, and PH2. Further investigation of technique and ethnicity effects on ICH and outcomes after AIS thrombectomy is warranted.
Databáze: OpenAIRE
Externí odkaz: