Clinical significance of intracranial hemorrhage after thrombectomy detected solely by magnetic resonance imaging and not by computed tomography.

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  • Additional Information
    • Source:
      Publisher: Elsevier Country of Publication: Netherlands NLM ID: 0375403 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1878-5883 (Electronic) Linking ISSN: 0022510X NLM ISO Abbreviation: J Neurol Sci Subsets: MEDLINE
    • Publication Information:
      Original Publication: Amsterdam : Elsevier, <19 ->
    • Subject Terms:
      Magnetic Resonance Imaging* ; Thrombectomy*/methods ; Thrombectomy*/adverse effects ; Intracranial Hemorrhages*/diagnostic imaging ; Intracranial Hemorrhages*/etiology ; Tomography, X-Ray Computed*; Humans ; Male ; Female ; Aged ; Retrospective Studies ; Middle Aged ; Ischemic Stroke/diagnostic imaging ; Aged, 80 and over ; Treatment Outcome ; Clinical Relevance
    • Abstract:
      Background and Objective: Whether intracranial hemorrhage (ICH) detected using magnetic resonance imaging (MRI) affects the clinical outcomes of patients with large-vessel occlusion (LVO) treated with mechanical thrombectomy (MT) remains unclear. This study investigated the clinical features of ICH after MT detected solely by MRI.
      Methods: This was a retrospective analysis of patients with acute ischemic stroke and occlusion of the internal carotid artery or middle cerebral artery treated with MT between April 2011 and March 2021. Among 632 patients, patients diagnosed with no ICH using CT, with a pre-morbid modified Rankin Scale (mRS) score ≤ 2, and those who underwent MRI including T2* and computed tomography (CT) within 72 h from MT were enrolled. The main outcomes were the association between ICH detected solely by MRI and clinical outcomes at 90 days. Poor clinical outcomes were defined as mRS score > 2 at 90 days after onset.
      Results: Of the 246 patients, 29 (12%) had ICH on MRI (MRI-ICH(+)), and 217 (88%) were MRI-ICH(-). There was no significant difference between number of patients with MRI-ICH(+) experiencing poor (10 [12%]) and favorable (19 [12%]) outcomes. The mRS score at 90 days between patients with MRI-ICH (+) and MRI-ICH(-) was not significantly different (2 [1-4] vs. 2 [1-4], respectively). Higher age and lower ASPECTS were independent risk factors for poor outcomes, as shown by multivariate regression analysis. MRI-ICH(+) status was not associated with poor outcomes.
      Conclusions: ICH detected by MRI alone did not influence clinical outcomes in patients with LVO treated with MT.
      Competing Interests: Declaration of competing interest Kazumi Kimura received lecture fees from Bristol-Myers Squibb Co., Ltd., Nippon Boehringer Ingelheim Co., Ltd., Bayer Healthcare Co., Ltd., and Daiichi Sankyo Co.; research funding from Nippon Boehringer Ingelheim Co., Ltd., Daiichi Sankyo Co., Pfizer Japan Inc., Medtronic Co., Ltd., and Teijin Pharma Ltd.; and personal funding from the 38th Mihara Cerebrovascular Disorder Research Promotion Fund, Ltd.
      (Copyright © 2023. Published by Elsevier B.V.)
    • Contributed Indexing:
      Keywords: Intracranial hemorrhage; MRI; Mechanical thrombectomy
    • Publication Date:
      Date Created: 20240505 Date Completed: 20240510 Latest Revision: 20240510
    • Publication Date:
      20240511
    • Accession Number:
      10.1016/j.jns.2024.122999
    • Accession Number:
      38705135