Mechanical Thrombectomy in Patients with Acute Ischemic Stroke and Concomitant Intracranial Hemorrhage.
Research article published in Clinical neuroradiology (2022)
Abstract
PURPOSE: Intravenous thrombolysis and mechanical thrombectomy (MT) are standard of care in patients with acute ischemic stroke due to large vessel occlusion. Data on MT in patients with intracranial hemorrhage prior to intervention is limited to anecdotal reports, as these patients were excluded from thrombectomy trials. METHODS: We analyzed patients from an observational multicenter cohort with acute ischemic stroke and endovascular treatment, the German Stroke Registry-Endovascular Treatment trial, with intracranial hemorrhage before MT. Baseline characteristics, procedural parameters and functional outcome at 90 days were analyzed and compared to a propensity score matched cohort. RESULTS: Out of 6635 patients, we identified 32 patients (0.5%) with acute ischemic stroke due to large vessel occlusion and preinterventional intracranial hemorrhage who underwent MT. Risk factors of intracranial hemorrhage were head trauma, oral anticoagulation and intravenous thrombolysis. Overall mortality was high (50%) but among patients with a premorbid modified Rankin scale (mRS) of 0-2 (n = 15), good clinical outcome (mRS 0-2) at 90 days was achieved in 40% of patients. Periprocedural and outcome results did not differ between patients with and without preinterventional intracranial hemorrhage. CONCLUSION: Preinterventional intracranial hemorrhage in acute ischemic stroke patients with large vessel occlusion is rare. The use of MT is technically feasible and a substantial number of patients achieve good clinical outcome, indicating that MT should not be withheld in patients with preinterventional intracranial hemorrhage.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Resumen
Intravenous thrombolysis and mechanical thrombectomy (MT) are standard of care in patients with acute ischemic stroke due to large vessel occlusion. Data on MT in patients with intracranial hemorrhage prior to intervention is limited to anecdotal reports, as these patients were excluded from thrombectomy trials.
Por qué esto importa para la hirudoterapia
Este estudio observacional multicéntrico analizó la cohorte del German Stroke Registry-Endovascular Treatment e identificó a 32 de 6,635 pacientes (0.5%) que presentaron un accidente cerebrovascular isquémico agudo por oclusión de grandes vasos junto con hemorragia intracraneal antes de la trombectomía mecánica; la mortalidad global fue elevada (50%), sin embargo, entre aquellos con una escala de Rankin modificada premórbida de 0-2, el 40% logró un buen resultado, y los resultados periprocedimentales y de desenlace no difirieron de un grupo de comparación emparejado por propensión, lo que llevó a los autores a concluir que no se debe omitir la trombectomía en este escenario. Para ASH, esto ilustra los riesgos clínicos en el mundo real del eje coagulación/sangrado al que se relaciona la investigación del secretoma de la sanguijuela, subrayando cómo la trombosis y la hemorragia coexisten frecuentemente y complican el manejo. Este es un estudio de cohorte de un subgrupo pequeño y raro en la atención intervencionista del accidente cerebrovascular sin conexión con sanguijuelas o hirudoterapia; es contexto descriptivo, no evidencia para ninguna terapia basada en sanguijuelas.
Citación
Mechanical Thrombectomy in Patients with Acute Ischemic Stroke and Concomitant Intracranial Hemorrhage.
Weller et al. · Clinical neuroradiology, 2022
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Añadido a la biblioteca ASH: May 28, 2026 · Última actualización del sitio: June 18, 2026