Clinical relevance of intracranial hemorrhage after thrombectomy versus medical management for large core infarct: a secondary analysis of the SELECT2 randomized trial.
Document Type
Article
Publication Title
J Neurointerv Surg
Abstract
BACKGROUND: The incidence of intracerebral hemorrhage (ICH) and its effect on the outcomes after endovascular thrombectomy (EVT) for patients with large core infarcts have not been well-characterized.
METHODS: SELECT2 trial follow-up imaging was evaluated using the Heidelberg Bleeding Classification (HBC) to define hemorrhage grade. The association of ICH with clinical outcomes and treatment effect was examined.
RESULTS: Of 351 included patients, 194 (55%) and 189 (54%) demonstrated intracranial and intracerebral hemorrhage, respectively, with a higher incidence in EVT (134 (75%) and 130 (73%)) versus medical management (MM) (60 (35%) and 59 (34%), both P0.99) or modify EVT treatment effect (P
CONCLUSIONS: ICH was present in 75% of the EVT population, but PH or sICH were infrequent. The presence of any ICH did not worsen functional outcomes or modify EVT treatment effect at 90-day follow-up. The high rate of hemorrhages overall still represents an opportunity for adjunctive therapies in EVT patients with a large ischemic core.
First Page
120
Last Page
127
DOI
10.1136/jnis-2023-021219
Publication Date
1-17-2025
Recommended Citation
Chen, Michael; Joshi, Krishna C; Kolb, Bradley; Sitton, Clark W; Pujara, Deep Kiritbhai; Abraham, Michael G; Ortega-Gutierrez, Santiago; Kasner, Scott E; Hussain, Shazam M; Churilov, Leonid; Blackburn, Spiros; Sundararajan, Sophia; Hu, Yin C; Herial, Nabeel; Arenillas, Juan F; Tsai, Jenny P; Budzik, Ronald F; Hicks, William; Kozak, Osman; Yan, Bernard; Cordato, Dennis; Manning, Nathan W; Parsons, Mark; Hanel, Ricardo A; Aghaebrahim, Amin; Wu, Teddy; Cardona Portela, Pere; Gandhi, Chirag D; Al-Mufti, Fawaz; Perez de la Ossa, Natalia; Schaafsma, Joanna; Blasco, Jordi; Sangha, Navdeep; Warach, Steven; Kleinig, Timothy J; Johns, Hannah; Shaker, Faris; Abdulrazzak, Mohammad A; Ray, Abhishek; Sunshine, Jeffery; Opaskar, Amanda; Duncan, Kelsey R; Xiong, Wei; Al-Shaibi, Faisal K; Samaniego, Edgar A; Nguyen, Thanh N; Fifi, Johanna T; Tjoumakaris, Stavropoula I; Jabbour, Pascal; Mendes Pereira, Vitor; Lansberg, Maarten G; Sila, Cathy; Bambakidis, Nicholas C; Davis, Stephen; Wechsler, Lawrence; Albers, Gregory W; Grotta, James C; Ribo, Marc; Hassan, Ameer E; Campbell, Bruce; Hill, Michael D; and Sarraj, Amrou, "Clinical relevance of intracranial hemorrhage after thrombectomy versus medical management for large core infarct: a secondary analysis of the SELECT2 randomized trial." (2025). Neuroscience Articles. 15.
https://scholarlyworks.ohiohealth.com/neuroscience-articles/15