Microbleeds, Cerebral Hemorrhage, and Functional Outcome After Endovascular Thrombectomy.

Aged Aged, 80 and over Cerebral Hemorrhage / epidemiology Comorbidity Endovascular Procedures Female Functional Status Humans Ischemic Stroke / epidemiology Magnetic Resonance Imaging Male Middle Aged Postoperative Hemorrhage / epidemiology Retrospective Studies Thrombectomy

Journal

Neurology
ISSN: 1526-632X
Titre abrégé: Neurology
Pays: United States
ID NLM: 0401060

Informations de publication

Date de publication:
30 03 2021
Historique:
received: 15 02 2020
accepted: 23 12 2020
pubmed: 27 1 2021
medline: 13 4 2021
entrez: 26 1 2021
Statut: ppublish

Résumé

To determine whether pretreatment cerebral microbleeds (CMBs) presence and burden are correlated with an increased risk of intracranial hemorrhage (ICH) or poor functional outcome following endovascular thrombectomy (EVT) for acute ischemic stroke (AIS). Consecutive patients treated by EVT for anterior circulation AIS were retrospectively analyzed. Experienced neuroradiologists blinded to functional outcomes rated CMBs on T2*-MRI using a validated scale. We investigated associations of CMB presence and burden with ICH and poor clinical outcome at 3 months (modified Rankin Scale score >2). Among 513 patients, 281 (54.8%) had a poor outcome and 89 (17.3%) had ≥1 CMBs. A total of 190 (37%) patients experienced ICH; 66 (12.9%) were symptomatic. CMB burden was associated with poor outcome in a univariable analysis (odds ratio [OR], 1.18; 95% confidence interval [CI], 1.03-1.36 per 1-CMB increase; Poor functional outcome or ICH were not correlated with CMB presence or burden on pre-EVT MRI after adjustment for confounding factors. Excluding such patients from reperfusion therapies is unwarranted. This study provides Class II evidence that in patients with AIS undergoing EVT, after adjustment for confounding factors, the presence of CMBs is not significantly associated with clinical outcome or the risk of ICH.

Identifiants

DOI: 10.1212/WNL.0000000000011566 PMID: 33495380
pubmed: 33495380
pii: WNL.0000000000011566
doi: 10.1212/WNL.0000000000011566
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e1724-e1731

Informations de copyright

© 2021 American Academy of Neurology.

Auteurs

Imad Derraz (I)

From the Departments of Neuroradiology (I.D., F.C., C.D., R.A., P.-H.L., C.R., G.G., A.B., V.C.) and Neurology (N.G., I.M., C.A.), Hôpital Gui de Chauliac, Montpellier University Medical Center, France; and Department of Clinical and Experimental Medicine (R.M.), Section of Statistics, University of Pisa, Italy. i-derraz@chu-montpellier.fr.

Federico Cagnazzo (F)

From the Departments of Neuroradiology (I.D., F.C., C.D., R.A., P.-H.L., C.R., G.G., A.B., V.C.) and Neurology (N.G., I.M., C.A.), Hôpital Gui de Chauliac, Montpellier University Medical Center, France; and Department of Clinical and Experimental Medicine (R.M.), Section of Statistics, University of Pisa, Italy.

Nicolas Gaillard (N)

From the Departments of Neuroradiology (I.D., F.C., C.D., R.A., P.-H.L., C.R., G.G., A.B., V.C.) and Neurology (N.G., I.M., C.A.), Hôpital Gui de Chauliac, Montpellier University Medical Center, France; and Department of Clinical and Experimental Medicine (R.M.), Section of Statistics, University of Pisa, Italy.
ORCID: 0000-0002-5650-828X

Riccardo Morganti (R)

From the Departments of Neuroradiology (I.D., F.C., C.D., R.A., P.-H.L., C.R., G.G., A.B., V.C.) and Neurology (N.G., I.M., C.A.), Hôpital Gui de Chauliac, Montpellier University Medical Center, France; and Department of Clinical and Experimental Medicine (R.M.), Section of Statistics, University of Pisa, Italy.
ORCID: 0000-0001-7783-0262

Cyril Dargazanli (C)

From the Departments of Neuroradiology (I.D., F.C., C.D., R.A., P.-H.L., C.R., G.G., A.B., V.C.) and Neurology (N.G., I.M., C.A.), Hôpital Gui de Chauliac, Montpellier University Medical Center, France; and Department of Clinical and Experimental Medicine (R.M.), Section of Statistics, University of Pisa, Italy.

Raed Ahmed (R)

From the Departments of Neuroradiology (I.D., F.C., C.D., R.A., P.-H.L., C.R., G.G., A.B., V.C.) and Neurology (N.G., I.M., C.A.), Hôpital Gui de Chauliac, Montpellier University Medical Center, France; and Department of Clinical and Experimental Medicine (R.M.), Section of Statistics, University of Pisa, Italy.

Pierre-Henri Lefevre (PH)

From the Departments of Neuroradiology (I.D., F.C., C.D., R.A., P.-H.L., C.R., G.G., A.B., V.C.) and Neurology (N.G., I.M., C.A.), Hôpital Gui de Chauliac, Montpellier University Medical Center, France; and Department of Clinical and Experimental Medicine (R.M.), Section of Statistics, University of Pisa, Italy.

Carlos Riquelme (C)

From the Departments of Neuroradiology (I.D., F.C., C.D., R.A., P.-H.L., C.R., G.G., A.B., V.C.) and Neurology (N.G., I.M., C.A.), Hôpital Gui de Chauliac, Montpellier University Medical Center, France; and Department of Clinical and Experimental Medicine (R.M.), Section of Statistics, University of Pisa, Italy.

Isabelle Mourand (I)

From the Departments of Neuroradiology (I.D., F.C., C.D., R.A., P.-H.L., C.R., G.G., A.B., V.C.) and Neurology (N.G., I.M., C.A.), Hôpital Gui de Chauliac, Montpellier University Medical Center, France; and Department of Clinical and Experimental Medicine (R.M.), Section of Statistics, University of Pisa, Italy.

Gregory Gascou (G)

From the Departments of Neuroradiology (I.D., F.C., C.D., R.A., P.-H.L., C.R., G.G., A.B., V.C.) and Neurology (N.G., I.M., C.A.), Hôpital Gui de Chauliac, Montpellier University Medical Center, France; and Department of Clinical and Experimental Medicine (R.M.), Section of Statistics, University of Pisa, Italy.

Alain Bonafe (A)

From the Departments of Neuroradiology (I.D., F.C., C.D., R.A., P.-H.L., C.R., G.G., A.B., V.C.) and Neurology (N.G., I.M., C.A.), Hôpital Gui de Chauliac, Montpellier University Medical Center, France; and Department of Clinical and Experimental Medicine (R.M.), Section of Statistics, University of Pisa, Italy.
ORCID: 0000-0002-9187-1375

Caroline Arquizan (C)

From the Departments of Neuroradiology (I.D., F.C., C.D., R.A., P.-H.L., C.R., G.G., A.B., V.C.) and Neurology (N.G., I.M., C.A.), Hôpital Gui de Chauliac, Montpellier University Medical Center, France; and Department of Clinical and Experimental Medicine (R.M.), Section of Statistics, University of Pisa, Italy.

Vincent Costalat (V)

From the Departments of Neuroradiology (I.D., F.C., C.D., R.A., P.-H.L., C.R., G.G., A.B., V.C.) and Neurology (N.G., I.M., C.A.), Hôpital Gui de Chauliac, Montpellier University Medical Center, France; and Department of Clinical and Experimental Medicine (R.M.), Section of Statistics, University of Pisa, Italy.

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Classifications MeSH

questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Sujet âgé › Microbleeds, Cerebral Hemorrhage, and...
questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Sujet âgé › Sujet âgé de 80 ans ou plus › Microbleeds, Cerebral Hemorrhage, and...
questionsmedicales.fr › États, signes et symptômes pathologiques › Processus pathologiques › Hémorragie › Hémorragies intracrâniennes › Hémorragie cérébrale › Microbleeds, Cerebral Hemorrhage, and...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Facteurs épidémiologiques › Comorbidité › Microbleeds, Cerebral Hemorrhage, and...
questionsmedicales.fr › Procédures de chirurgie opératoire › Interventions chirurgicales mini-invasives › Procédures endovasculaires › Microbleeds, Cerebral Hemorrhage, and...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Mesures épidémiologiques › Démographie › État de santé › État fonctionnel › Microbleeds, Cerebral Hemorrhage, and...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Microbleeds, Cerebral Hemorrhage, and...
questionsmedicales.fr › Maladies cardiovasculaires › Maladies vasculaires › Angiopathies intracrâniennes › Accident vasculaire cérébral › Accident vasculaire cérébral ischémique › Microbleeds, Cerebral Hemorrhage, and...
questionsmedicales.fr › Diagnostic › Techniques et procédures diagnostiques › Imagerie diagnostique › Tomographie › Imagerie par résonance magnétique › Microbleeds, Cerebral Hemorrhage, and...
questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Adulte d'âge moyen › Microbleeds, Cerebral Hemorrhage, and...
questionsmedicales.fr › États, signes et symptômes pathologiques › Processus pathologiques › Complications postopératoires › Hémorragie postopératoire › Microbleeds, Cerebral Hemorrhage, and...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études rétrospectives › Microbleeds, Cerebral Hemorrhage, and...
questionsmedicales.fr › Procédures de chirurgie opératoire › Procédures de chirurgie cardiovasculaire › Procédures de chirurgie vasculaire › Thrombectomie › Microbleeds, Cerebral Hemorrhage, and...