| Subarachnoid Hemorrhage in a Multimodal Approach Heavily Weighted Toward Mechanical Thrombectomy With Solitaire Stent in Acute Stroke. | |
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MedLine Citation:
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PMID: 23287788 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND AND PURPOSE: Subarachnoid hemorrhage (SAH) may appear on computerized tomography scans after mechanical thrombectomy for acute ischemic stroke. The incidence and prognosis of this observation remain unknown. We investigated the frequency and clinical consequences of SAH after treating acute ischemic stroke with multimodal approach heavily weighted toward mechanical thrombectomy with Solitaire stent. METHODS: Seventy-four consecutive patients with acute ischemic stroke underwent mechanical thrombectomy with a Solitaire stent as a first-line treatment. Nonenhanced computerized tomography scans were performed before, immediately after, and 24 hours after treatment to detect SAH. Clinical outcome was assessed after treatment, on day 1, at discharge, and at 3 months. Clinical and radiological data were compared between patients with and without SAH. RESULTS: Twelve patients (16.2%) exhibited SAH associated with pure SAH (n=4) or mixed SAH and contrast extravasation (n=8). The SAH was located in the ipsilateral Sylvian fissure (n=11) or bilateral parietooccipital sulci (n=1). Patients with SAH had no periprocedural vessel perforations or arterial dissections and no postprocedural neurological deteriorations. Rescue angioplasty was performed more frequently in SAH group than in control group (33.3% vs 9.7%; P=0.05). Patients with SAH and those without had similar recanalization rates and clinical outcomes. CONCLUSIONS: SAH on post-therapeutic computerized tomography scans were not uncommon after primary mechanical thrombectomy with a Solitaire stent, but they seemed to be benign. Rescue angioplasty and unidentified, small vessel ruptures due to mechanical stretch during stent retrieval might give rise to these lesions. |
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Authors:
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Woong Yoon; Min Young Jung; Se Hee Jung; Man Seok Park; Joon Tae Kim; Heoung Keun Kang |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2013-1-3 |
Journal Detail:
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Title: Stroke; a journal of cerebral circulation Volume: - ISSN: 1524-4628 ISO Abbreviation: Stroke Publication Date: 2013 Jan |
Date Detail:
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Created Date: 2013-1-4 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0235266 Medline TA: Stroke Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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From the Chonnam National University Hospital, Gwangju, Korea. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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