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Impact of post-thrombectomy isolated subarachnoid hemorrhage on neurological outcomes in patients with anterior ischemic stroke – a retrospective single-center observational study

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Název: Impact of post-thrombectomy isolated subarachnoid hemorrhage on neurological outcomes in patients with anterior ischemic stroke – a retrospective single-center observational study
Autoři: Natalie van Landeghem, Christoph Ziegenfuß, Aydin Demircioglu, Philipp Dammann, Ramazan Jabbarli, Johannes Haubold, Michael Forsting, Isabel Wanke, Martin Köhrmann, Benedikt Frank, Cornelius Deuschl, Yan Li
Zdroj: Neuroradiology
Informace o vydavateli: Springer Science and Business Media LLC, 2024.
Rok vydání: 2024
Témata: Male, Interventional Neuroradiology, Medizin, Female [MeSH], Ischemic Stroke/surgery [MeSH], Postoperative Complications [MeSH], Aged [MeSH], Thrombectomy/methods [MeSH], Humans [MeSH], Retrospective Studies [MeSH], Mechanical thrombectomy, Middle Aged [MeSH], Subarachnoid Hemorrhage/complications [MeSH], Bleeding, Subarachnoid Hemorrhage/diagnostic imaging [MeSH], Stroke, Male [MeSH], Subarachnoid Hemorrhage/surgery [MeSH], Hemorrhage, SAH, Subarachnoid Hemorrhage, Middle Aged, 03 medical and health sciences, Postoperative Complications, 0302 clinical medicine, Humans, Female, Retrospective Studies, Ischemic Stroke, Thrombectomy, Aged
Popis: Purpose We aimed to investigate the impact of post-thrombectomy isolated subarachnoid hemorrhage (i-SAH) and other types of intracranial hemorrhage (o-ICH) on patient’s neurological outcomes. Methods Stroke data from 2018 to 2022 in a tertiary care center were retrospectively analyzed. Patients with large vessel occlusion from ICA to M2 branch were included. Post-thrombectomy intracranial hemorrhages at 24 h were categorized with Heidelberg Bleeding Classification. Neurological impairment of patients was continuously assessed at admission, at 24 h, 48 h and 72 h, and at discharge. Predictors of i-SAH and o-ICH were assessed. Results 297 patients were included. i-SAH and o-ICH were found in 12.1% (36/297) and 11.4% (34/297) of patients. Overall, NIHSS of i-SAH patients at discharge were comparable to o-ICH patients (median 22 vs. 21, p = 0.889) and were significantly higher than in non-ICH patients (22 vs. 7, p p p = 0.022). Regardless of successful reperfusion (TICI 2b/3), the beneficial impact of thrombectomy appeared to be outweighed by the adverse effect of i-SAH. Incomplete reperfusion and shorter time from symptom onset to admission were associated with higher probability of i-SAH, whereas longer procedure time and lower baseline ASPECTS were predictive for o-ICH occurrence. Conclusion Post-thrombectomy isolated subarachnoid hemorrhage is a common complication with significant negative impact on neurological outcome.
Druh dokumentu: Article
Other literature type
Jazyk: English
ISSN: 1432-1920
0028-3940
DOI: 10.1007/s00234-024-03424-w
Přístupová URL adresa: https://pubmed.ncbi.nlm.nih.gov/38980345
https://repository.publisso.de/resource/frl:6522232
Rights: CC BY
Přístupové číslo: edsair.doi.dedup.....9f4182c45f50addf639cea941c4a5e3f
Databáze: OpenAIRE
Popis
Abstrakt:Purpose We aimed to investigate the impact of post-thrombectomy isolated subarachnoid hemorrhage (i-SAH) and other types of intracranial hemorrhage (o-ICH) on patient’s neurological outcomes. Methods Stroke data from 2018 to 2022 in a tertiary care center were retrospectively analyzed. Patients with large vessel occlusion from ICA to M2 branch were included. Post-thrombectomy intracranial hemorrhages at 24 h were categorized with Heidelberg Bleeding Classification. Neurological impairment of patients was continuously assessed at admission, at 24 h, 48 h and 72 h, and at discharge. Predictors of i-SAH and o-ICH were assessed. Results 297 patients were included. i-SAH and o-ICH were found in 12.1% (36/297) and 11.4% (34/297) of patients. Overall, NIHSS of i-SAH patients at discharge were comparable to o-ICH patients (median 22 vs. 21, p = 0.889) and were significantly higher than in non-ICH patients (22 vs. 7, p p p = 0.022). Regardless of successful reperfusion (TICI 2b/3), the beneficial impact of thrombectomy appeared to be outweighed by the adverse effect of i-SAH. Incomplete reperfusion and shorter time from symptom onset to admission were associated with higher probability of i-SAH, whereas longer procedure time and lower baseline ASPECTS were predictive for o-ICH occurrence. Conclusion Post-thrombectomy isolated subarachnoid hemorrhage is a common complication with significant negative impact on neurological outcome.
ISSN:14321920
00283940
DOI:10.1007/s00234-024-03424-w