Risk factors and predictors of intracranial hemorrhage after mechanical thrombectomy in acute ischemic stroke: Insights from the Stroke Thrombectomy and Aneurysm Registry (STAR)

Natasha Ironside, Ching Jen Chen, Reda M. Chalhoub, Peter Wludyka, Ryan T. Kellogg, Sami Al Kasab, Dale Ding, Ilko Maier, Ansaar Rai, Pascal Jabbour, Joon Tae Kim, Stacey Q. Wolfe, Robert M. Starke, Marios Nikos Psychogios, Amir Shaban, Adam S. Arthur, Shinichi Yoshimura, Jonathan A. Grossberg, Ali Alawieh, Isabel FragataAdam J. Polifka, Justin R. Mascitelli, Joshua W. Osbun, Charles Matouk, Michael R. Levitt, Travis M. Dumont, Hugo H. Cuellar-Saenz, Richard Williamson, Daniele G. Romano, Roberto Javier Crosa, Benjamin Gory, Maxim Mokin, Mark Moss, Kaustubh Limaye, Peter Kan, Alejandro M. Spiotta, Min S. Park

Producción científica: Articlerevisión exhaustiva

6 Citas (Scopus)

Resumen

Background Reducing intracranial hemorrhage (ICH) can improve patient outcome in acute ischemic stroke (AIS) intervention. We sought to identify ICH risk factors after AIS thrombectomy. Methods This is a retrospective review of the Stroke Thrombectomy and Aneurysm Registry (STAR) database. All patients who underwent AIS thrombectomy with available ICH data were included. Multivariable regression models were developed to identify predictors of ICH after thrombectomy. Subgroup analyses were performed stratified by symptom status and European Cooperative Acute Stroke Study (ECASS) grade. Results The study cohort comprised 6860 patients. Any ICH and symptomatic ICH (sICH) occurred in 25% and 7% of patients, respectively. Hemorrhagic infarction 1 (HI1) occurred in 36%, HI2 in 24%, parenchymal hemorrhage 1 (PH1) in 22%, and PH2 in 17% of patients classified by ECASS grade. Intraprocedural complications independently predicted any ICH (OR 3.8083, P<0.0001), PH1 (OR 1.9053, P=0.0195), and PH2 (OR 2.7347, P=0.0004). Race also independently predicted any ICH (black: OR 0.5180, P=0.0017; Hispanic: OR 0.4615, P=0.0148), sICH (non-white: OR 0.4349, P=0.0107), PH1 (non-white: OR 3.1668, P<0.0001), and PH2 (non-white: OR 1.8689, P=0.0176), with white as the reference. Primary mechanical thrombectomy technique also independently predicted ICH. ADAPT (A Direct Aspiration First Pass Technique) was a negative predictor of sICH (OR 0.2501, P<0.0001), with stent retriever as the reference. Conclusions This study identified ICH risk factors after AIS thrombectomy using real-world data. There was a propensity towards a reduced sICH risk with direct aspiration. Procedural complications and ethnicity were predictors congruent between categories of any ICH, sICH, PH1, and PH2. Further investigation of technique and ethnicity effects on ICH and outcomes after AIS thrombectomy is warranted.

Idioma originalEnglish (US)
Páginas (desde-hasta)E312-E322
PublicaciónJournal of neurointerventional surgery
Volumen15
N.ºe2
DOI
EstadoPublished - nov 1 2023

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Huella

Profundice en los temas de investigación de 'Risk factors and predictors of intracranial hemorrhage after mechanical thrombectomy in acute ischemic stroke: Insights from the Stroke Thrombectomy and Aneurysm Registry (STAR)'. En conjunto forman una huella única.

Citar esto