دورية أكاديمية
Hemorrhage rates in patients with acute ischemic stroke treated with intravenous alteplase and thrombectomy versus thrombectomy alone
| العنوان: | Hemorrhage rates in patients with acute ischemic stroke treated with intravenous alteplase and thrombectomy versus thrombectomy alone |
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| المؤلفون: | van Kranendonk, Katinka R, Kappelhof, Manon, Bruggeman, Agnetha A E, Rinkel, Leon A, Treurniet, Kilian M, LeCouffe, Natalie, Emmer, Bart J, Coutinho, Jonathan M, Wolff, Lennard, van Zwam, Wim H, van Oostenbrugge, Robert J, van der Lugt, Aad, Dippel, Diederik W J, Roos, Yvo B W E M, Marquering, Henk A, Majoie, Charles B L M, MR CLEAN-NO IV Investigators, Roos, Yvo, Majoie, Charles, Treurniet, Kilian, Coutinho, Jonathan, Emmer, Bart, Rinkel, Leon, Bruggeman, Agnetha, Roozenbeek, Bob, Es, Adriaan van, Ridder, Inger de, Zwam, Wim van, Worp, Bart van der, Lo, Rob, Keizer, Koos, Gons, Rob, Yo, Lonneke, Boiten, Jelis, Wijngaard, Ido van den, LycklamaNijeholt, Geert LycklamaGeert, Lycklama, Geert, Hofmeijer, Jeannette, Martens, Jasper, Schonewille, Wouter, Vos, Jan Albert, Tuladhar, Anil, Schreuder, Floris, Boogaarts, Jeroen, Jenniskens, Sjoerd, Laat, Karlijn de, Dijk, Lukas van, Hertog, Heleen den, Hasselt, Boudewijn van, Brouwers, Paul, Sturm, Emiel, Bulut, Tomas, Remmers, Michel, Norden, Anouk van, Jong, Thijs de, Rozeman, Anouk, Elgersma, Otto, Uyttenboogaart, Maarten, Bokkers, Reinoud, Tuijl, Julia van, Boukrab, Issam, Kortman, Hans, Costalat, Vincent, Arquizan, Caroline, Lemmens, Robin, Demeestere, Jelle, Desfontaines, Philippe, Brisbois, Denis, Clarencon, Frédéric, Samson, Yves, Brown, Martin, White, Phil, Gregson, John, Nieboer, Daan, Dippel, Diederik, Nuland, Rick van, Lugt, Aad van der, Jacobi, Linda, Berg, Renévan den, Beenen, Ludo, Doormaal, Pieter-Jan van, Yoo, Albert, Hammer, Bas, Roosendaal, Stefan, Meijer, Anton, Krietemeijer, Menno, Hoorn, Anouk van der, Gerrits, Dick, Oostenbrugge, Robert van, Ben Jansen, Sanne Manschot, Kerkhof, Henk, Koudstaal, Peter, Lingsma, Hester, Chalos, Vicky, Berkhemer, Olvert, Versteeg, Adriaan, Su, Jiahang, Tolhuisen, Manon, Voorst, Henk van, Cate, Hugo ten, Maat, Moniek de, Donse-Donkel, Samantha, Beusekom, Heleen van, Taha, Aladdin, Berg, Sophie van den, Graaf, Rob van de, Goldhoorn, Robert-Jan, Hinsenveld, Wouter, Pirson, Anne, Sondag, Lotte, Reinink, Rik, Brouwer, Josje, Collette, Sabine, Steen, Wouter van der, Sprengers, Rita, Sterrenberg, Martin, Ghannouti, Naziha El, Verheesen, Sabrina, Pellikaan, Wilma, Blauwendraat, Kitty, Drabbe, Yvonne, Meris, Joke de, Simons, Michelle, Bongenaar, Hester, Loon, Anja van, Ponjee, Eva, Eilander, Rieke, Kooij, Suze, Jong, Marieke de, Santegoets, Esther, Roodenburg, Suze, Ahee, Ayla van, Moynier, Marinette, Devroye, Annemie, Marcis, Evelyn, Iezzi, Ingrid, David, Annie, Talbi, Atika, Heiligers, Leontien, Martens, Yvonne |
| بيانات النشر: | BMJ Publishing Group Ltd |
| سنة النشر: | 2023 |
| المجموعة: | HighWire Press (Stanford University) |
| مصطلحات موضوعية: | Ischemic stroke |
| الوصف: | Background Intravenous alteplase treatment (IVT) for acute ischemic stroke carries a risk of intracranial hemorrhage (ICH). However, reperfusion of an occluded vessel itself may contribute to the risk of ICH. We determined whether IVT and reperfusion are associated with ICH or its volume in the Multicenter Randomized Clinical trial of Endovascular treatment for Acute ischemic stroke in the Netherlands (MR CLEAN)-NO IV trial. Methods The MR CLEAN-NO IV trial randomized patients with acute ischemic stroke due to large vessel occlusion to receive either IVT followed by endovascular treatment (EVT) or EVT alone. ICH was classified according to the Heidelberg bleeding classification on follow-up MRI or CT approximately 8 hours−7 days after stroke. Hemorrhage volume was measured with ITK-snap. Successful reperfusion was defined as extended Thrombolysis In Cerebral Infarction (eTICI) score of 2b-3. Multinomial and binary adjusted logistic regression were used to determine the association of IVT and reperfusion with ICH subtypes. Results Of 539 included patients, 173 (32%) developed ICH and 30 suffered from symptomatic ICH (sICH) (6%). Of the patients with ICH, 102 had hemorrhagic infarction, 47 had parenchymal hematoma, 44 had SAH, and six had other ICH. Reperfusion was associated with a decreased risk of SAH, and IVT was not associated with SAH (eTICI 2b-3: adjusted OR 0.45, 95% CI 0.21 to 0.97; EVT without IVT: OR 1.6, 95% CI 0.91 to 2.8). Reperfusion status and IVT were not associated with overall ICH, hemorrhage volume, and sICH (sICH: EVT without IVT, OR 0.96, 95% CI 0.41 to 2.25; eTICI 2b-3, OR 0.49, 95% CI 0.23 to 1.05). Conclusion Neither IVT administration before EVT nor successful reperfusion after EVT were associated with ICH, hemorrhage volume, and sICH. SAH occurred more often in patients for whom successful reperfusion was not achieved. |
| نوع الوثيقة: | text |
| وصف الملف: | text/html |
| اللغة: | English |
| العلاقة: | http://jnis.bmj.com/cgi/content/short/15/e2/e262Test; http://dx.doi.org/10.1136/jnis-2022-019569Test |
| DOI: | 10.1136/jnis-2022-019569 |
| الإتاحة: | https://doi.org/10.1136/jnis-2022-019569Test http://jnis.bmj.com/cgi/content/short/15/e2/e262Test |
| حقوق: | Copyright (C) 2023, Society of NeuroInterventional Surgery |
| رقم الانضمام: | edsbas.875EF993 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1136/jnis-2022-019569 |
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