Hemorrhage rates in patients with acute ischemic stroke treated with intravenous alteplase and thrombectomy versus thrombectomy alone Article Swipe
Katinka R. van Kranendonk
,
Manon Kappelhof
,
Agnetha A.E. Bruggeman
,
Leon A. Rinkel
,
Kilian M. Treurniet
,
Natalie E. LeCouffe
,
Bart J. Emmer
,
Jonathan M. Coutinho
,
Lennard Wolff
,
Wim H. van Zwam
,
Robert J. van Oostenbrugge
,
Aad van der Lugt
,
Diederik W.J. Dippel
,
Yvo B.W.E.M. Roos
,
Henk A. Marquering
,
Charles B.L.M. Majoie
·
YOU?
·
· 2022
· Open Access
·
· DOI: https://doi.org/10.1136/jnis-2022-019569
YOU?
·
· 2022
· Open Access
·
· DOI: https://doi.org/10.1136/jnis-2022-019569
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.
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Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1136/jnis-2022-019569
- https://jnis.bmj.com/content/neurintsurg/early/2022/11/17/jnis-2022-019569.full.pdf
- OA Status
- bronze
- Cited By
- 6
- References
- 48
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4309361507
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
-
https://openalex.org/W4309361507Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.1136/jnis-2022-019569Digital Object Identifier
- Title
-
Hemorrhage rates in patients with acute ischemic stroke treated with intravenous alteplase and thrombectomy versus thrombectomy aloneWork title
- Type
-
articleOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2022Year of publication
- Publication date
-
2022-11-17Full publication date if available
- Authors
-
Katinka R. van Kranendonk, Manon Kappelhof, Agnetha A.E. Bruggeman, Leon A. Rinkel, Kilian M. Treurniet, Natalie E. LeCouffe, Bart J. Emmer, Jonathan M. Coutinho, Lennard Wolff, Wim H. van Zwam, Robert J. van Oostenbrugge, Aad van der Lugt, Diederik W.J. Dippel, Yvo B.W.E.M. Roos, Henk A. Marquering, Charles B.L.M. MajoieList of authors in order
- Landing page
-
https://doi.org/10.1136/jnis-2022-019569Publisher landing page
- PDF URL
-
https://jnis.bmj.com/content/neurintsurg/early/2022/11/17/jnis-2022-019569.full.pdfDirect link to full text PDF
- Open access
-
YesWhether a free full text is available
- OA status
-
bronzeOpen access status per OpenAlex
- OA URL
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https://jnis.bmj.com/content/neurintsurg/early/2022/11/17/jnis-2022-019569.full.pdfDirect OA link when available
- Concepts
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Medicine, Stroke (engine), Ischemic stroke, Cardiology, Surgery, Anesthesia, Ischemia, Mechanical engineering, EngineeringTop concepts (fields/topics) attached by OpenAlex
- Cited by
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6Total citation count in OpenAlex
- Citations by year (recent)
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2025: 5, 2023: 1Per-year citation counts (last 5 years)
- References (count)
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48Number of works referenced by this work
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10Other works algorithmically related by OpenAlex
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