Background: Endovascular treatment (EVT) of tandem lesion (TL) in the anterior circulation acute ischemic stroke (IS) usually requires periprocedural antithrombotic treatment and early initiation of dual antiplatelet therapy (DAPT) after carotid stenting. However, it may contribute to an occurrence of symptomatic intracerebral hemorrhage (SICH) in some cases. We investigated factors influencing the SICH occurrence and assessed the possible predictors of SICH after EVT.
Methods: IS patients with TL in the anterior circulation treated with EVT were enrolled in the multicenter retrospective ASCENT study. A good three-month clinical outcome was scored as 0-2 points in modified Rankin Scale (mRS) and recanalization using the TICI scale. SICH was assessed using the SITS-MOST criteria. Logistic regression analysis was used for the assessment of possible predictors of SICH with adjustment for potential confounders.
Results: In total, 300 (68.7 % males, mean age 67.3 ± 10.2 years) patients with median of admission NIHSS 17 were analyzed. Recanalization (TICI 2b-3) was achieved in 290 (96.7 %) patients and 176 (58.7 %) had mRS 0-2. SICH occurred in 25 (8.3 %) patients. Patients with SICH did not differ from those without SICH in the rate of periprocedural antithrombotic treatment (64 vs. 57.5 %, p = 0.526) and in the rate of DAPT started within the first 12 h after EVT (20 vs. 42.2 %, p = 0.087). After adjustment, admission NIHSS and admission glycemia were found as the only predictors of SICH after EVT.
Conclusion: Admission NIHSS and glycemia were found as the only predictors of SICH after EVT for TL. No associations between periprocedural antithrombotic treatment, early start of DAPT after EVT and SICH occurrence were found.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2024.107852 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
A cross-sectional study on the correlation between internal cerebral vein asymmetry and hemorrhagic transformation following endovascular thrombectomy.
Front Neurol
January 2025
Department of Neurology and Institute of Neurology of First Affiliated Hospital, Institute of Neuroscience, Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, Fuzhou, China.
Introduction: Hemorrhagic transformation (HT) is a severe complication in patients with acute ischemic stroke due to large vessel occlusion (AIS-LVO) after endovascular treatment (EVT). We hypothesize that asymmetry of the internal cerebral veins (ICVs) on baseline CT angiogram (CTA) may serve as an adjunctive predictor of HT.
Methods: We conducted a study on consecutive AIS-LVO patients from November 2020 to April 2022.
Altered brain glymphatic function on diffusion-tensor MRI in patients with spontaneous intracerebral hemorrhage: an exploratory study.
Front Aging Neurosci
December 2024
Department of Radiology, Qilu Hospital (Qingdao) of Shandong University, Qingdao, China.
Objectives: To investigate the function of the glymphatic system (GS) and its association with neuropsychological tests in spontaneous intracerebral hemorrhage (sICH) by diffusion tensor imaging analysis along the perivascular space (DTI-ALPS).
Methods: This retrospective study included 58 patients with sICH and 63 age- and sex-matched healthy controls (HCs). Partial correlation analyses were performed to examine the relationships between the DTI-ALPS index and radiological as well as clinical data.
Malignant solid tumor-related spontaneous intracerebral hemorrhage: a propensity score matching study.
PeerJ
December 2024
Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.
Background: Spontaneous intracerebral hemorrhage (sICH) is a severe event with high mortality. Recently, evidence has emerged suggesting that malignant solid tumors may increase the risk of sICH through unique cancer-related factors. However, the specific risk factors and clinical characteristics of sICH in patients with malignant solid tumor remain poorly understood.
View Article and Find Full Text PDFEffectiveness and Safety of Mechanical Thrombectomy in Large-Vessel-Occlusion Mild Stroke: Insights from the ASSIST Registry.
AJNR Am J Neuroradiol
December 2024
From the Department of Department of Neuroradiology, University Hospital Heidelberg (S.H.; D. F. V.; M. A. M.); Neuroradiology, Hospital Son Espases, Mallorca, Spain (S.M.); Interventional Neurology, McLaren Regional Medical Center, Flint, Michigan, USA (B.N.); Interventional Neurology, McLaren Regional Medical Center, Macomb, Michigan, USA (B.N.); Neurosurgery, Medical University of South Carolina, Charleston, SC, USA (A.S.); Radiology and Neuroradiology, Klinikum Vest Recklinghausen, Recklinghausen, Germany (C.L.); Interventional Neuroradiology/Endovascular Neurosurgery, Hospital Clínico Universitario de Valladolid, Valladolid, Spain (M.M.G.); Interventional Neuroradiology, Rhode Island Hospital, Providence, Rhode Island, USA (R.M.T.); Vascular and Interventional Radiology, Ghent University Hospital, Ghent, Belgium (L.D.); Radiology, Hospital Universitario Central de Asturias-HUCA, Oviedo, Spain (P.V.); Neuroscience Department, Bon Secours Mercy Health St. Vincent Medical Center, Toledo, Ohio, USA (O.O.Z); Stryker Neurovascular, Fremont, California, USA (P.J.); Neuroradiology Unit, Radiology Department, University Hospital "G. Martino" Messina, Messina, Italy (S.L.V., A.T.); Department of Neurology and Comprehensive Stroke Center, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA (D.S.L.); Wellstar Medical Group, Neurosurgery, WellStar Health System, Marietta, Georgia, USA (R.G.).
Background And Purpose: Mechanical thrombectomy (MT) is effective for acute ischemic stroke, yet its indication in mild stroke remains unclear. This study evaluates MT's effectiveness and safety in low NIHSS patients and assesses different MT strategies' impact on procedural success and clinical outcomes.
Materials And Methods: Data from the ASSIST Registry were analyzed, categorizing patients with large vessel occlusion of the anterior circulation into mild (NIHSS≤5) and moderate-severe (NIHSS>5) stroke groups.
Stroke thrombectomy in the elderly: A propensity score matched study on a nationwide real-world registry.
Eur Stroke J
November 2024
IRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Neurologia e Rete Stroke Metropolitana, Bologna, Italy.
Introduction: Data on safety and efficacy of endovascular thrombectomy (EVT) for acute ischemic stroke in older patients are limited and controversial, and people aged 80 or older were under-represented in randomized trials. Our aim was to assess EVT effect for ischemic stroke patients aged ⩾80 at a nationwide level.
Patients And Methods: The cohort included stroke patients undergoing EVT from the Italian Registry of Endovascular Treatment in Acute Stroke (IRETAS).
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!