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01-04-2019 | Stroke | Interventional Neuroradiology

Risk factors of intracranial hemorrhage after mechanical thrombectomy of anterior circulation ischemic stroke

Authors: Ulf Neuberger, Philipp Kickingereder, Silvia Schönenberger, Simon Schieber, Peter A. Ringleb, Martin Bendszus, Johannes Pfaff, Markus A. Möhlenbruch

Published in: Neuroradiology | Issue 4/2019

Abstract

Purpose

Intracranial hemorrhage (ICH) is a potentially severe complication after mechanical thrombectomy (MT). Here, we investigated risk factors for the occurrence of any and symptomatic ICH after MT due to large-vessel occlusion of the anterior circulation.

Methods

Consecutive patients with acute ischemic anterior circulation stroke with large-vessel occlusion undergoing MT were analyzed. ICH was categorized according to the Heidelberg Bleeding Classification. Forty-three procedural and clinical parameters were analyzed using univariate tests and multivariate logistic regressions.

Results

Of 612 patients, any ICH was detected in 195 (31.9%), while 27 (4.4%) developed a symptomatic ICH. Infarct size > 1/3 of vascular territory in control imaging (OR 2.18, 95% CI 1.45–3.21), higher serum glucose levels (OR 1.23 for change of 15 units mg/dL, 95% CI 1.10–1.39), and higher thrombectomy maneuver count (OR 1.21, 95% CI 1.11–1.32) were significantly associated with a higher risk of developing any ICH compared to no ICH. Wake-up strokes (OR 3.99, 95% CI 1.38–11.60), transfer from an external clinic (OR 3.04, 95% CI 1.24–7.48), and higher serum glucose levels (OR 1.22 for change of 15 units mg/dL, 95% CI 1.05–1.42) were revealed as independent risk factors for development of symptomatic ICH compared to no symptomatic ICH. Patients with no infarct demarcation (OR 0.10, 95% CI 0.01–0.80) and complete recanalization (OR 0.57, 95% CI 0.37–0.86) showed a lower risk of developing any ICH.

Conclusion

Wake-up strokes and patients who are treated within a drip-and-ship concept are especially vulnerable for symptomatic ICH, while complete recanalization, contrary to subtotal recanalization only, was revealed as a protective factor against ICH.

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Title: Risk factors of intracranial hemorrhage after mechanical thrombectomy of anterior circulation ischemic stroke
Authors: Ulf Neuberger
Philipp Kickingereder
Silvia Schönenberger
Simon Schieber
Peter A. Ringleb
Martin Bendszus
Johannes Pfaff
Markus A. Möhlenbruch
Publication date: 01-04-2019
Publisher: Springer Berlin Heidelberg
Keywords: Stroke
Thrombectomy
Published in: Neuroradiology / Issue 4/2019
Print ISSN: 0028-3940
Electronic ISSN: 1432-1920
DOI: https://doi.org/10.1007/s00234-019-02180-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Risk factors of intracranial hemorrhage after mechanical thrombectomy of anterior circulation ischemic stroke

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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