The impact of SAH finding on CT to the clinical outcome after mechanical thrombectomy for large vessel occlusion

被引：3

作者：

Suzuki, Kentaro ^{[23
]}

Matsumaru, Yuji ^{[1
]}

Takeuchi, Masataka ^{[2
]}

Morimoto, Masafumi ^{[3
]}

Kanazawa, Ryuzaburo ^{[4
]}

Takayama, Yohei ^{[5
]}

Kamiya, Yuki ^{[6
]}

Shigeta, Keigo ^{[7
]}

Okubo, Seiji ^{[6
]}

Hayakawa, Mikito ^{[1
]}

Ishii, Norihiro ^{[8
]}

Koguchi, Yorio ^{[9
]}

Takigawa, Tomoji ^{[10
]}

Inoue, Masato ^{[11
]}

Naito, Hiromichi ^{[12
]}

Ota, Takahiro ^{[13
]}

Hirano, Teruyuki ^{[14
]}

Kato, Noriyuki ^{[15
]}

Ueda, Toshihiro ^{[16
]}

Iguchi, Yasuyuki ^{[17
]}

Akaji, Kazunori

Tsuruta, Wataro ^{[19
]}

Miki, Kazunori ^{[20
]}

Fujimoto, Shigeru ^{[21
]}

Higashida, Tetsuhiro ^{[5
]}

Iwasaki, Mitsuhiro ^{[4
,18
]}

Aoki, Junya ^{[1
]}

Nishiyama, Yasuhiro ^{[1
]}

Otsuka, Toshiaki ^{[22
]}

机构：

[1] Nippon Med Sch, Dept Neurol, Tokyo, Japan

[2] Univ Tsukuba, Fac Med, Dept Neurosurg, Div Stroke Prevent & Treatment, Ibaraki, Japan

[3] Seisho Hosp, Dept Neurosurg, Odawara, Kanagawa, Japan

[4] Yokohama Shintoshi Neurosurg Hosp, Dept Neurosurg, Yokohama, Kanagawa, Japan

[5] Nagareyama Cent Hosp, Dept Neurosurg, Chiba, Japan

[6] Akiyama Neurosurg Hosp, Dept Neurol, Yokohama, Kanagawa, Japan

[7] NTT Med Ctr Tokyo, Dept Cerebrovasc Med, Tokyo, Japan

[8] Natl Hosp Org Disaster Med Ctr, Dept Neurosurg, Tokyo, Japan

[9] New Tokyo Hosp, Dept Neurosurg, Chiba, Japan

[10] Chiba Emergency Med Ctr, Dept Neurol & Neurosurg, Chiba, Japan

[11] Dokkyo Med Univ, Saitama Med Ctr, Dept Neurosurg, Saitama, Japan

[12] Natl Ctr Global Hlth & Med, Dept Neurosurg, Tokyo, Japan

[13] Funabashi Municipal Med Ctr, Dept Neurosurg, Chiba, Japan

[14] Tokyo Metropolitan Tama Med Ctr, Dept Neurosurg, Tokyo, Japan

[15] Mito Med Ctr, Dept Neurosurg, Ibaraki, Japan

[16] St Marianna Univ, Toyoko Hosp, Stroke Ctr, Dept Strokol, Kawasaki, Kanagawa, Japan

[17] Jikei Univ, Sch Med, Dept Neurol, Tokyo, Japan

[18] Mihara Mem Hosp, Dept Neurosurg, Gunma, Japan

[19] Toranomon Gen Hosp, Dept Endovasc Neurosurg, Tokyo, Japan

[20] Tokyo Med & Dent Univ, Dept Endovasc Surg, Tokyo, Japan

[21] Jichi Med Univ, Dept Med, Div Neurol, Tochigi, Japan

[22] Nippon Med Sch, Dept Hyg & Publ Hlth, Tokyo, Japan

[23] Nippon Med Sch, Dept Neurol, 1-1-5 Sendagi,Bunkyo Ku, Tokyo 1138602, Japan

来源：

JOURNAL OF THE NEUROLOGICAL SCIENCES | 2023年 / 453卷

关键词：

Subarachnoid haemorrhage; Ischemic stroke; Mechanical thrombectomy; Clinical outcome; ACUTE ISCHEMIC-STROKE; SUBARACHNOID HEMORRHAGE; STENT; RETRIEVER;

D O I：

10.1016/j.jns.2023.120797

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Background and purpose: Whether subarachnoid haemorrhage (SAH) after mechanical thrombectomy affects the clinical outcomes of patients with acute large-vessel occlusion remains unclear. This study aimed to investigate the clinical impact of SAH on computed tomography (CT) after mechanical thrombectomy.Methods: The SKIP study was an investigator-initiated, multicentre, randomised, open-label clinical trial. This study was performed in 23 hospital networks in Japan from January 1, 2017, to July 31, 2019. Among the 204 patients, seven were excluded because they did not undergo mechanical thrombectomy (MT) and had a modified Rankin scale (mRS) score > 2. The main outcome was the association between SAH within 36 h after mechanical thrombectomy and the clinical outcome at 90 days.Results: Among 197 patients, the median age was 74 (67-79) years, 62.9% were male. Moreover, 26 (13.2%) patients had SAH (seven isolated SAH) on CT within 36 h. The SAH rate did not differ according to IV rt-PA administration (p = 0.4). The rate of favourable clinical outcomes tended to be lower in patients with SAH rather than patients without SAH (11 [42%] vs. 106 [62%], p = 0.08). Among the seven patients with isolated SAH, 6 showed favourable outcomes at 90 days. In the multivariate regression analysis, the presence of SAH within 36 h from onset was not associated with clinical outcome (Odd ratio, 0.59; 95% confidence interval, 0.18-1.95; p = 0.38).Conclusions: Among patients with acute stroke treated with MT, SAH, especially isolated SAH findings on CT, were not associated with poor clinical outcomes after 90 days. Trial Registration number: UMIN000021488.

引用

页数：6

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