Asymptomatic Intracerebral Hemorrhage Following Endovascular Stroke Therapy Is Not Benign: A Systematic Review and Meta‐Analysis

作者：Pablo Harker, Yasmin Aziz, Justin E. Vranic, Roberto Chulluncuy‐Rivas, Melissa J. Previtera, Shadi R. Yaghi, Adam de Havenon, Georgios K. Tsivgoulis, Vivek Khatri, Akshitkumar M. Mistry, Pooja Kumari Khatri, Eva A. Mistry · 发表于：Journal of the American Heart Association · 年份：2024 · DOI：10.1161/jaha.123.031749 · 被引用次数：33 · 研究领域：Intracerebral and Subarachnoid Hemorrhage Research、Acute Ischemic Stroke Management、Intracranial Aneurysms: Treatment and Complications

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 <0.0001, I 2 46% Q 19.15) and mortality (OR, 1.72 [95% CI, 1.17–2.53], P :0.005, I 2 79% Q 27.59) compared with no ICH. This diff...