Incidence of intracranial hemorrhagic complications after anterior circulation endovascular thrombectomy in relation to occlusion site : a nationwide observational register study
Hall, Emma LU
; Ullberg, Teresa
LU
; Andsberg, Gunnar
LU
and Wasselius, Johan
LU
(2023)
In Journal of NeuroInterventional Surgery
- Abstract
BACKGROUND: Intracranial hemorrhage (ICH) is a potentially severe complication of endovascular thrombectomy (EVT). However, the relationship between the incidence and severity of ICH and vascular occlusion location is not well described.
OBJECTIVE: To present a comprehensive analysis of subtypes of ICHs and their relationship to the occlusion site following EVT in the anterior circulation.
METHODS: All patients with anterior circulation vessel occlusion stroke (internal carotid (ICA) and middle cerebral artery's first (M1) and later segments (M2 and beyond)) registered in the two Swedish national quality registers for stroke care and endovascular therapy during 2015-2020 were included. Hemorrhagic complications identified on... (More)
BACKGROUND: Intracranial hemorrhage (ICH) is a potentially severe complication of endovascular thrombectomy (EVT). However, the relationship between the incidence and severity of ICH and vascular occlusion location is not well described.
OBJECTIVE: To present a comprehensive analysis of subtypes of ICHs and their relationship to the occlusion site following EVT in the anterior circulation.
METHODS: All patients with anterior circulation vessel occlusion stroke (internal carotid (ICA) and middle cerebral artery's first (M1) and later segments (M2 and beyond)) registered in the two Swedish national quality registers for stroke care and endovascular therapy during 2015-2020 were included. Hemorrhagic complications identified on imaging within 36 hours post-EVT were classified according to Heidelberg Bleeding Classification and further divided into symptomatic (sICH) or non-symptomatic (non-sICH).
RESULTS: Of the 3077 patients, ICH frequency was 24.2%, which included 4.5% sICH. Subarachnoid hemorrhage (SAH) was the most frequent subtype of hemorrhage (10.9%). The hemorrhagic subtypes differed significantly by occlusion site, but the frequency of any bleed did not. EVT performed in and beyond the M2 more often resulted in SAH, frequently classified as non-sICH. EVT performed in the ICA was associated with more severe hemorrhages, such as intraventricular and large parenchymal hematomas, that were more often classified as sICH.
CONCLUSION: In this nationwide unselected EVT cohort we found that ICH severity significantly differed between different vessel occlusion sites.
(Less)
- author
- Hall, Emma
LU
; Ullberg, Teresa
LU
; Andsberg, Gunnar
LU
and Wasselius, Johan
LU
- organization
- publishing date
- 2023-10-05
- type
- Contribution to journal
- publication status
- epub
- subject
- in
- Journal of NeuroInterventional Surgery
- publisher
- BMJ Publishing Group
- external identifiers
-
- scopus:85174256384
- pmid:37798105
- ISSN
- 1759-8478
- DOI
- 10.1136/jnis-2023-020768
- language
- English
- LU publication?
- yes
- additional info
- © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
- id
- 2fc67bd8-43cb-4b69-89c8-ea47c0d5625b
- date added to LUP
- 2023-11-16 10:04:25
- date last changed
- 2024-06-09 22:44:37
@article{2fc67bd8-43cb-4b69-89c8-ea47c0d5625b,
abstract = {{<p>BACKGROUND: Intracranial hemorrhage (ICH) is a potentially severe complication of endovascular thrombectomy (EVT). However, the relationship between the incidence and severity of ICH and vascular occlusion location is not well described.</p><p>OBJECTIVE: To present a comprehensive analysis of subtypes of ICHs and their relationship to the occlusion site following EVT in the anterior circulation.</p><p>METHODS: All patients with anterior circulation vessel occlusion stroke (internal carotid (ICA) and middle cerebral artery's first (M1) and later segments (M2 and beyond)) registered in the two Swedish national quality registers for stroke care and endovascular therapy during 2015-2020 were included. Hemorrhagic complications identified on imaging within 36 hours post-EVT were classified according to Heidelberg Bleeding Classification and further divided into symptomatic (sICH) or non-symptomatic (non-sICH).</p><p>RESULTS: Of the 3077 patients, ICH frequency was 24.2%, which included 4.5% sICH. Subarachnoid hemorrhage (SAH) was the most frequent subtype of hemorrhage (10.9%). The hemorrhagic subtypes differed significantly by occlusion site, but the frequency of any bleed did not. EVT performed in and beyond the M2 more often resulted in SAH, frequently classified as non-sICH. EVT performed in the ICA was associated with more severe hemorrhages, such as intraventricular and large parenchymal hematomas, that were more often classified as sICH.</p><p>CONCLUSION: In this nationwide unselected EVT cohort we found that ICH severity significantly differed between different vessel occlusion sites.</p>}},
author = {{Hall, Emma and Ullberg, Teresa and Andsberg, Gunnar and Wasselius, Johan}},
issn = {{1759-8478}},
language = {{eng}},
month = {{10}},
publisher = {{BMJ Publishing Group}},
series = {{Journal of NeuroInterventional Surgery}},
title = {{Incidence of intracranial hemorrhagic complications after anterior circulation endovascular thrombectomy in relation to occlusion site : a nationwide observational register study}},
url = {{http://dx.doi.org/10.1136/jnis-2023-020768}},
doi = {{10.1136/jnis-2023-020768}},
year = {{2023}},
}