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Determinants of Symptomatic Intracranial Hemorrhage After Endovascular Stroke Treatment: A Retrospective Cohort Study

2022; Lippincott Williams & Wilkins; Volume: 53; Issue: 9 Linguagem: Inglês

10.1161/strokeaha.121.036195

1524-4628

Wouter van der Steen, Nadinda A.M. van der Ende, Katinka R. van Kranendonk, Vicky Chalos, Robert J. van Oostenbrugge, Wim H. van Zwam, Yvo B.W.E.M. Roos, Pieter‐Jan van Doormaal, Adriaan C.G.M. van Es, Hester F. Lingsma, Charles B.L.M. Majoie, Aad van der Lugt, Diederik W.J. Dippel, Bob Roozenbeek, Jelis Boiten, Jan Albert Vos, Ivo G.H. Jansen, Maxim J.H.L. Mulder, Robert‐ Jan B. Goldhoorn, Kars C.J. Compagne, Manon Kappelhof, Josje Brouwer, Sanne J. den Hartog, Bart J. Emmer, Jonathan M. Coutinho, Wouter J. Schonewille, Jan Albert Vos, Marieke J.H. Wermer, Marianne A.A. van Walderveen, Julie Staals, Jeannette Hofmeijer, Jasper M. Martens, Geert J. Lycklama à Nijeholt, Jelis Boiten, Sebastiaan F. de Bruijn, Lukas C. van Dijk, H. Bart van der Worp, Rob H. Lo, Ewoud J. van Dijk, Hieronymus D. Boogaarts, Joost de Vries, Paul L.M. de Kort, Julia van Tuijl, Jo P. Peluso, Puck Fransen, Jan S.P. van den Berg, Boudewijn A.A.M. van Hasselt, Leo A.M. Aerden, René J. Dallinga, Maarten Uyttenboogaart, Omid Eschgi, Reinoud P.H. Bokkers, Tobien H.C.M.L. Schreuder, Roel J.J. Heijboer, Koos Keizer, Lonneke S.F. Yo, Heleen M. den Hertog, Tomas Bulut, Paul J.A.M. Brouwers, Geert J. Lycklama, Marianne A.A. van Walderveen, Marieke E.S. Sprengers, Sjoerd F.M. Jenniskens, René van den Berg, Albert J. Yoo, Ludo F.M. Beenen, Alida A. Postma, Stefan D. Roosendaal, Bas F.W. van der Kallen, Ido R. van den Wijngaard, Bart J. Emmer, Jasper M. Martens, Lonneke S.F. Yo, Jan Albert Vos, Joost Bot, Anton Meijer, Elyas Ghariq, Reinoud P.H. Bokkers, Marc P. van Proosdij, G. Menno Krietemeijer, Jo P. Peluso, Hieronymus D. Boogaarts, Rob H. Lo, Wouter Dinkelaar, P.A. Auke, Bas Hammer, Sjoert Pegge, Anouk van der Hoorn, Saman Vinke, Geert J. Lycklama à Nijeholt, Jelis Boiten, Jan Albert Vos, Jeannette Hofmeijer, Jasper M. Martens, H. Bart van der Worp, Jeannette Hofmeijer, H. Zwenneke Flach, Naziha el Ghannouti, Martin Sterrenberg, Wilma Pellikaan, Rita Sprengers, Marjan Elfrink, Michelle Simons, Marjolein Vossers, Joke de Meris, Tamara Vermeulen, Annet Geerlings, Gina van Vemde, Tiny Simons, Gert Messchendorp, Nynke Nicolaij, Hester Bongenaar, Karin Bodde, Sandra Kleijn, Jasmijn Lodico, Hanneke Droste, Maureen Wollaert, Sabrina Verheesen, D. Jeurrissen, Erna Bos, Yvonne Drabbe, Michelle Sandiman, Nicoline Aaldering, Berber Zweedijk, Jocova Vervoort, Eva Ponjee, Sharon Romviel, Karin Kanselaar, Denn Barning, Esmée Venema, Ralph R. Geuskens, Tim van Straaten, Saliha Ergezen, Roger R.M. Harmsma, Daan Muijres, Anouk de Jong, Olvert A. Berkhemer, Anna M.M. Boers, J. Huguet, P.F.C. Groot, Marieke A. Mens, Kilian M. Treurniet, Manon L. Tolhuisen, Heitor Alves, Annick J. Weterings, Eleonora L.F. Kirkels, Eva J.H.F. Voogd, Lieve M. Schupp, Sabine L. Collette, Adrien E.D. Groot, Natalie E. LeCouffe, Praneeta R. Konduri, Haryadi Prasetya, Nerea Arrarte Terreros, Lucas A. Ramos, Martin M. Brown, Thomas Liebig, Esther van der Heijden, Naziha el Ghannouti, Nadine Fleitour, Imke Hooijenga, Corina Puppels, Wilma Pellikaan, Annet Geerling, Annemieke Lindl-Velema, Gina van Vemde, Ans de Ridder, Paut Greebe, Jose de Bont- Stikkelbroeck, Joke de Meris, M C Haaglanden, Kirsten Janssen, Silvan Licher, Nikki Boodt, Adriaan Ros, Esmée Venema, Ilse Slokkers, Raymie-Jayce Ganpat, Maxim J.H.L. Mulder, Nawid Saiedie, Alis Heshmatollah, Stefanie Schipperen, Stefan Vinken, Tiemen van Boxtel, Jeroen Koets, Merel Boers, Emilie Santos, Jordi Borst, Ivo G.H. Jansen, Manon Kappelhof, Marit Lucas, Ralph R. Geuskens, Roeland Sales Barros,

Intracerebral and Subarachnoid Hemorrhage Research

Symptomatic intracranial hemorrhage (sICH) is a serious complication after endovascular treatment for ischemic stroke. We aimed to identify determinants of its occurrence and location.We retrospectively analyzed data from the Dutch MR CLEAN trial (Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands) and MR CLEAN registry. We included adult patients with a large vessel occlusion in the anterior circulation who underwent endovascular treatment within 6.5 hours of stroke onset. We used univariable and multivariable logistic regression analyses to identify determinants of overall sICH occurrence, sICH within infarcted brain tissue, and sICH outside infarcted brain tissue.SICH occurred in 203 (6%) of 3313 included patients and was located within infarcted brain tissue in 50 (25%), outside infarcted brain tissue in 23 (11%), and both within and outside infarcted brain tissue in 116 (57%) patients. In 14 patients (7%), data on location were missing. Prior antiplatelet use, baseline systolic blood pressure, baseline plasma glucose levels, post-endovascular treatment modified treatment in cerebral ischemia score, and duration of procedure were associated with all outcome parameters. In addition, determinants of sICH within infarcted brain tissue included history of myocardial infarction (adjusted odds ratio, 1.65 [95% CI, 1.06-2.56]) and poor collateral score (adjusted odds ratio, 1.42 [95% CI, 1.02-1.95]), whereas determinants of sICH outside infarcted brain tissue included level of occlusion on computed tomography angiography (internal carotid artery or internal carotid artery terminus compared with M1: adjusted odds ratio, 1.79 [95% CI, 1.16-2.78]).Several factors, some potentially modifiable, are associated with sICH occurrence. Further studies should investigate whether modification of baseline systolic blood pressure or plasma glucose level could reduce the risk of sICH. In addition, determinants differ per location of sICH, supporting the hypothesis of varying underlying mechanisms.URL: https://www.isrctn.com/; Unique identifier: ISRCTN10888758.