Time to recanalization and risk of symptomatic intracerebral haemorrhage in patients treated with intravenous thrombolysis

European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies
L DoradoA Dávalos

Abstract

To test whether time to recanalization is associated with a progressive risk of symptomatic intracerebral haemorrhage (SICH) after intravenous alteplase (IVT), we conducted a serial transcranial duplex monitoring study up to 24 h after IVT in a cohort of 140 patients with acute ischaemic stroke attributed to large artery occlusion in the anterior circulation. Patients were classified in four groups according to the time to complete recanalization (Thrombolysis in Brain Ischaemia, TIBI grades 4 or 5) after alteplase bolus: <2 h (n = 53), 2-6 h (n = 9), 6-24 h (n = 32) and no recanalization (NR) at 24 h (n = 46). SICH was defined as any haemorrhagic transformation with National Institute of Health Stroke Scale (NIHSS) score worsening ≥ 4 points (European Australian Acute Stroke Study II, ECASS II criteria) or parenchymal haematoma type 2 with neurological worsening (SITS-MOST criteria) in the 24-36 h CT. Favourable outcome was defined as modified Rankin score ≤ 2 at 3 months. There were no differences between the groups of patients who recanalized at each time frame regarding localization of the occlusion (P = 0.29), stroke severity at baseline (P = 0.22) and age (P = 0.06). SICH (ECASS/SITS-MOST) was observed in 5.7%/5.7% of the...Continue Reading

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Citations

Jun 4, 2013·Lancet Neurology·José Álvarez-SabínCarlos S Kase
Dec 4, 2014·Diagnostic and Interventional Imaging·G TurcD Calvet
Jan 18, 2014·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·A H V Schapira
Nov 3, 2016·Stroke; a Journal of Cerebral Circulation·Patrick LydenKent Pryor
Jul 22, 2018·Frontiers in Neurology·Nathan W ManningAndrew Cheung

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