RT Journal Article
SR Electronic
T1 Predictors of parenchymal hemorrhage after endovascular treatment in acute ischemic stroke: data from ANGEL-ACT Registry
JF Journal of NeuroInterventional Surgery
JO J NeuroIntervent Surg
FD BMJ Publishing Group Ltd.
SP neurintsurg-2021-018292
DO 10.1136/neurintsurg-2021-018292
A1 Dapeng Sun
A1 Baixue Jia
A1 Xu Tong
A1 Peter Kan
A1 Xiaochuan Huo
A1 Anxin Wang
A1 Raynald
A1 Gaoting Ma
A1 Ning Ma
A1 Feng Gao
A1 Dapeng Mo
A1 Ligang Song
A1 Xuan Sun
A1 Lian Liu
A1 Yiming Deng
A1 Xiaoqing Li
A1 Bo Wang
A1 Gang Luo
A1 Yongjun Wang
A1 Zeguang Ren
A1 Zhongrong Miao
A1 ,
YR 2022
UL http://jnis.bmj.com/content/early/2022/01/11/neurintsurg-2021-018292.abstract
AB Background Parenchymal hemorrhage (PH) is a troublesome complication after endovascular treatment (EVT).Objective To investigate the incidence, independent predictors, and clinical impact of PH after EVT in patients with acute ischemic stroke (AIS) due to anterior circulation large vessel occlusion (LVO).Methods Subjects were selected from the ANGEL-ACT Registry. PH was diagnosed according to the European Collaborative Acute Stroke Study classification. Logistic regression analyses were performed to determine the independent predictors of PH, as well as the association between PH and 90-day functional outcome assessed by modified Rankin Scale (mRS) score.Results Of the 1227 enrolled patients, 147 (12.0%) were diagnosed with PH within 12–36 hours after EVT. On multivariable analysis, low admission Alberta Stroke Program Early CT score (ASPECTS)(adjusted OR (aOR)=1.13, 95% CI 1.02 to 1.26, p=0.020), serum glucose >7 mmol/L (aOR=1.82, 95% CI 1.16 to 2.84, p=0.009), and neutrophil-to-lymphocyte ratio (NLR; aOR=1.05, 95% CI 1.02 to 1.09, p=0.005) were associated with a high risk of PH, while underlying intracranial atherosclerotic stenosis (ICAS; aOR=0.42, 95% CI 0.22 to 0.81, p=0.009) and intracranial angioplasty/stenting (aOR=0.37, 95% CI 0.15 to 0.93, p=0.035) were associated with a low risk of PH. Furthermore, patients with PH were associated with a shift towards to worse functional outcome (mRS score 4 vs 3, adjusted common OR (acOR)=2.27, 95% CI 1.53 to 3.38, p<0.001).Conclusions In Chinese patients with AIS caused by anterior circulation LVO, the risk of PH was positively associated with low admission ASPECTS, serum glucose >7 mmol/L, and NLR, but negatively related to underlying ICAS and intracranial angioplasty/stenting.Trial registration number NCT03370939.Data are available upon reasonable request. Not applicable.