Alpha 2.0
Login Register
» Articles » PMID: 38260038

Symptomatic Intracranial Hemorrhage After Mechanical Thrombectomy - the Difference Between Iso-Osmolar and Low-Osmolar Contrast Media

Overview
Journal J Neuroendovasc Ther
Specialty Neurology
Date 2024 Jan 23
PMID 38260038
Authors
Takeshi Wada
Katsutoshi Takayama
Kaoru Myouchin
Hayato Kishida
Yuto Chanoki
Keisuke Oshima
Takahiro Masutani
Yoshitomo Uchiyama
Toshihiro Tanaka
Affiliations
Soon will be listed here.
Abstract

Objective: Symptomatic intracranial hemorrhage (SICH) after mechanical thrombectomy (MT) is generally considered a critical complication. Hemorrhagic transformation after ischemic stroke has also been associated with contrast media administration. The objective of our study was to evaluate correlations between contrast media type and incidence of SICH after MT.

Methods: Ninety-three consecutive patients (41 men; mean age, 80.2 years; range, 44-98 years) underwent MT reperfusion (expanded thrombolysis in cerebral infarction score, 2a-3) for acute large-vessel occlusion ischemic stroke within 8 h after symptom onset between April 2020 and July 2023 were retrospectively reviewed. Correlations between contrast media type (iso-osmolar or low-osmolar medium) and incidence of SICH were assessed.

Results: Contrast media were iso-osmolar in 60 cases or low-osmolar in 33 cases. The overall incidence of SICH was 5.5%. The frequency of SICH was significantly lower in the iso-osmolar group (1.7%) than in the low-osmolar group (12.1%; P = 0.033).

Conclusion: Iso-osmolar contrast media was associated with a lower incidence of SICH compared with low-osmolar contrast media in patients after MT.

Citing Articles

A clinical and computed tomography-based nomogram to predict the outcome in patients with anterior circulation large vessel occlusion after endovascular mechanical thrombectomy.

Wang T, Jin X, Yang P, Li S, Zhang Q, Shao C Jpn J Radiol. 2024; 42(9):973-982.

PMID: 38700623 DOI: 10.1007/s11604-024-01583-7.

References
1.
Zhang X, Xie Y, Wang H, Yang D, Jiang T, Yuan K . Symptomatic Intracranial Hemorrhage After Mechanical Thrombectomy in Chinese Ischemic Stroke Patients: The ASIAN Score. Stroke. 2020; 51(9):2690-2696. DOI: 10.1161/STROKEAHA.120.030173. View
2.
von Kummer R, Broderick J, Campbell B, Demchuk A, Goyal M, Hill M . The Heidelberg Bleeding Classification: Classification of Bleeding Events After Ischemic Stroke and Reperfusion Therapy. Stroke. 2015; 46(10):2981-6. DOI: 10.1161/STROKEAHA.115.010049. View
3.
Hao Y, Yang D, Wang H, Zi W, Zhang M, Geng Y . Predictors for Symptomatic Intracranial Hemorrhage After Endovascular Treatment of Acute Ischemic Stroke. Stroke. 2017; 48(5):1203-1209. DOI: 10.1161/STROKEAHA.116.016368. View
4.
Khatri P, Broderick J, Khoury J, Carrozzella J, Tomsick T . Microcatheter contrast injections during intra-arterial thrombolysis may increase intracranial hemorrhage risk. Stroke. 2008; 39(12):3283-7. PMC: 2587523. DOI: 10.1161/STROKEAHA.108.522904. View
5.
Mazighi M, Richard S, Lapergue B, Sibon I, Gory B, Berge J . Safety and efficacy of intensive blood pressure lowering after successful endovascular therapy in acute ischaemic stroke (BP-TARGET): a multicentre, open-label, randomised controlled trial. Lancet Neurol. 2021; 20(4):265-274. DOI: 10.1016/S1474-4422(20)30483-X. View