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14-02-2024 | Stroke | Original Communication

Cerebral microbleeds and risk of symptomatic hemorrhagic transformation following mechanical thrombectomy for large vessel ischemic stroke

Authors: Rémi Agbonon, Géraud Forestier, Nicolas Bricout, Wagih Benhassen, Guillaume Turc, Martin Bretzner, Marco Pasi, Joseph benzakoun, Pierre Seners, Imad Derraz, Laurence Legrand, Denis Trystram, Christine Rodriguez-Regent, Andreas Charidimou, Natalia S. Rost, Serge Bracard, Charlotte Cordonnier, Omer F. Eker, Catherine Oppenheim, Olivier Naggara, Hilde Henon, Grégoire Boulouis

Published in: Journal of Neurology | Issue 5/2024

Abstract

Background and purpose

In patients with acute ischemic stroke (AIS) treated with endovascular therapy (EVT), the association of pre-existing cerebral small vessel disease (cSVD) with symptomatic intracerebral hemorrhage (sICH) remains controversial. We tested the hypothesis that the presence of cerebral microbleeds (CMBs) and their burden would be associated with sICH after EVT of AIS.

Methods

We conducted a retrospective study combining cohorts of patients that underwent EVT between January 1st 2015 and January 1st 2020. CMB presence, burden, and other cSVD markers were assessed on a pre-treatment MRI, evaluated independently by two observers. Primary outcome was the occurrence of sICH.

Results

445 patients with pretreatment MRI were included, of which 70 (15.7%) demonstrated CMBs on baseline MRI. sICH occurred in 36 (7.6%) of all patients. Univariate analysis did not demonstrate an association between CMB and the occurrence of sICH (7.5% in CMB+ group vs 8.6% in CMB group, p = 0.805). In multivariable models, CMBs’ presence was not significantly associated with increased odds for sICH (-aOR- 1.19; 95% CI [0.43–3.27], p = 0.73). Only ASPECTs (aOR 0.71 per point increase; 95% CI [0.60–0.85], p < 0.001) and collaterals status (aOR 0.22 for adequate versus poor collaterals; 95% CI [0.06–0.93], p 0.019) were independently associated with sICH.

Conclusion

CMB presence and burden is not associated with increased occurrence of sICH after EVT. This result incites not to exclude patients with CMBs from EVT. The risk of sICH after EVT in patients with more than10 CMBs will require further investigation.

Registration

Registration-URL: http://www.clinicaltrials.gov; Unique identifier: NCT01062698.

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Title: Cerebral microbleeds and risk of symptomatic hemorrhagic transformation following mechanical thrombectomy for large vessel ischemic stroke
Authors: Rémi Agbonon
Géraud Forestier
Nicolas Bricout
Wagih Benhassen
Guillaume Turc
Martin Bretzner
Marco Pasi
Joseph benzakoun
Pierre Seners
Imad Derraz
Laurence Legrand
Denis Trystram
Christine Rodriguez-Regent
Andreas Charidimou
Natalia S. Rost
Serge Bracard
Charlotte Cordonnier
Omer F. Eker
Catherine Oppenheim
Olivier Naggara
Hilde Henon
Grégoire Boulouis
Publication date: 14-02-2024
Publisher: Springer Berlin Heidelberg
Keywords: Stroke
Cerebral Small Vessel Disease
Thrombectomy
Published in: Journal of Neurology / Issue 5/2024
Print ISSN: 0340-5354
Electronic ISSN: 1432-1459
DOI: https://doi.org/10.1007/s00415-024-12205-7

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Springer Medicine

Cerebral microbleeds and risk of symptomatic hemorrhagic transformation following mechanical thrombectomy for large vessel ischemic stroke

Abstract

Background and purpose

Methods

Results

Conclusion

Registration

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background and purpose

Methods

Results

Conclusion

Registration

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