The following is a summary of “Cerebral microbleeds and risk of symptomatic hemorrhagic transformation following mechanical thrombectomy for large vessel ischemic stroke,” published in the February 2024 issue of Neurology by Agbonon et al.
Despite receiving endovascular therapy (EVT) for acute ischemic stroke (AIS), the link between pre-existing cerebral small vessel disease (cSVD) and symptomatic intracerebral hemorrhage (sICH) remains unclear.
Researchers conducted a retrospective study to see if cerebral microbleeds (CMBs) presence and quantity predicted sICH in stroke patients treated with EVT.
They combined cohorts of patients who underwent EVT (January 1, 2015, and January 1, 2020). CMB presence, burden, and other cSVD markers were evaluated on a pre-treatment MRI and independently assessed by two observers. The primary outcome was the occurrence of sICH.
The results showed 445 patients who had pretreatment MRI, 70 (15.7%) had CMBs, and sICH occurred in 36 (7.6%) patients overall. Univariate analysis found no link between CMB presence and sICH occurrence (7.5% in the CMB+ group vs 8.6% in the CMB group, P=0.805). In multivariable models, CMB presence wasn’t significantly linked to higher odds for sICH (-aOR- 1.19; 95% CI [0.43–3.27], P=0.73). Only ASPECTs (aOR 0.71 per point increase; 95% CI [0.60–0.85], P<0.001) and collaterals status (aOR 0.22 for adequate versus poor collaterals, 95% CI [0.06–0.93], P 0.019) were independently associated with sICH.
Investigators concluded that while CMBs didn’t predict sICH after stroke therapy, further study is needed for EVT patients with numerous CMBs as their sICH risk remains unclear.
Source: link.springer.com/article/10.1007/s00415-024-12205-7