학술논문

Asymptomatic Intracerebral Hemorrhage Following Endovascular Stroke Therapy Is Not Benign: A Systematic Review and Meta‐Analysis
Document Type
article
Source
Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, Vol 13, Iss 4 (2024)
Subject
acute ischemic stroke
endovascular thrombectomy
symptomatic intracerebral hemorrhage
Diseases of the circulatory (Cardiovascular) system
RC666-701
Language
English
ISSN
2047-9980
Abstract
Background Asymptomatic intracerebral hemorrhage (aICH) occurs in approximately 35% of patients with acute ischemic stroke after endovascular thrombectomy. Unlike symptomatic ICH, studies evaluating the effect of aICH on outcomes have been inconclusive. We performed a systematic review and meta‐analysis to evaluate the long‐term effects of postendovascular thrombectomy aICH. Methods and Results The meta‐analysis protocol was submitted to the International Prospective Register of Systematic Reviews a priori. PubMed, Scopus, and Web of Science were searched from inception through September 2023, yielding 312 studies. Two authors independently reviewed all abstracts. Included studies contained adult patients with ischemic stroke undergoing endovascular thrombectomy with follow‐up imaging assessment of ICH reporting comparative outcomes according to aICH versus no ICH. After screening, 60 papers were fully reviewed, and 10 studies fulfilled inclusion criteria (n=5723 patients total, 1932 with aICH). Meta‐analysis was performed using Cochrane RevMan v5.4. Effects were estimated by a random‐effects model to estimate summary odds ratio (OR) of the effect of aICH versus no ICH on primary outcomes of 90‐day modified Rankin Scale 3 to 6 and mortality. The presence of aICH was associated with a higher odds of 90‐day mRS 3 to 6 (OR, 2.17 [95% CI, 1.81–2.60], P