We have located links that may give you full text access.
Clinically asymptomatic hemorrhagic conversion is associated with need for inpatient rehabilitation following mechanical thrombectomy for anterior circulation ischemic stroke.
World Neurosurgery 2024 March 26
BACKGROUND: Hemorrhagic conversion (HC) is a known complication following acute ischemic stroke(AIS) in patients undergoing mechanical thrombectomy(MT). While symptomatic HC(sHC) has been shown to lead to poor neurologic outcomes, the effect of asymptomatic HC(aHC) is unclear. This study aims to identify predictors of aHC and to determine the short-term outcomes.
METHODS: This is a single-institution retrospective study of patients with anterior circulation stroke(AIS) who underwent MT between January 2016 and September 2022. Radiographic HC was identified on post-operative imaging. Asymptomatic hemorrhage was defined as no acute neurologic decline attributable to imaging findings. Baseline characteristics, technical aspects, and outcomes were compared between aHC and no HC groups. Logistic regression and multivariate analysis were performed.
RESULTS: 615 patients underwent MT for AIS, of which 496 met inclusion criteria. 235 (47.4%) patients had evidence of aHC. Diabetes mellitus (OR 1.59; 95% CI 1.06 - 2.41; p=0.03), hyperglycemia (OR 1.01; 95% CI 1.00 - 1.01; p=0.002), greater number of passes (OR 1.14; 95% CI 1.00 - 1.31; p=0.05), and longer time to reperfusion (OR 1.02; 95% CI 1.00 - 1.05; p=0.05) were associated with aHC. Patients with aHC were significantly more likely to require rehabilitation, whereas those without HC were more likely to discharge home (p<0.001). There were no significant differences in long-term outcomes.
CONCLUSION: HC occurred in up to half of patients who underwent MT for AIS, of which the majority were clinically asymptomatic. Despite clinical stability, aHC was significantly associated greater need for inpatient rehabilitation. Predictors of aHC included hyperglycemia and longer time to reperfusion.
METHODS: This is a single-institution retrospective study of patients with anterior circulation stroke(AIS) who underwent MT between January 2016 and September 2022. Radiographic HC was identified on post-operative imaging. Asymptomatic hemorrhage was defined as no acute neurologic decline attributable to imaging findings. Baseline characteristics, technical aspects, and outcomes were compared between aHC and no HC groups. Logistic regression and multivariate analysis were performed.
RESULTS: 615 patients underwent MT for AIS, of which 496 met inclusion criteria. 235 (47.4%) patients had evidence of aHC. Diabetes mellitus (OR 1.59; 95% CI 1.06 - 2.41; p=0.03), hyperglycemia (OR 1.01; 95% CI 1.00 - 1.01; p=0.002), greater number of passes (OR 1.14; 95% CI 1.00 - 1.31; p=0.05), and longer time to reperfusion (OR 1.02; 95% CI 1.00 - 1.05; p=0.05) were associated with aHC. Patients with aHC were significantly more likely to require rehabilitation, whereas those without HC were more likely to discharge home (p<0.001). There were no significant differences in long-term outcomes.
CONCLUSION: HC occurred in up to half of patients who underwent MT for AIS, of which the majority were clinically asymptomatic. Despite clinical stability, aHC was significantly associated greater need for inpatient rehabilitation. Predictors of aHC included hyperglycemia and longer time to reperfusion.
Full text links
Related Resources
Trending Papers
A Guide to the Use of Vasopressors and Inotropes for Patients in Shock.Journal of Intensive Care Medicine 2024 April 14
British Society for Rheumatology guideline on management of adult and juvenile onset Sjögren disease.Rheumatology 2024 April 17
Albumin: a comprehensive review and practical guideline for clinical use.European Journal of Clinical Pharmacology 2024 April 13
Renin-Angiotensin-Aldosterone System: From History to Practice of a Secular Topic.International Journal of Molecular Sciences 2024 April 5
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app