{
  "abstract": "Introduction Mechanical thrombectomy (MT) has shown efficacy in patients with large core infarcts, yet hemorrhagic complications remain a major safety concern. Intracranial hemorrhage (ICH), particularly symptomatic ICH (sICH), may compromise clinical benefit. The TENSION trial demonstrated the safety and efficacy of MT in patients with large infarcts (ASPECTS 3–5), but factors influencing hemorrhagic risk remain to be clarified.Aim of Study This sub-analysis of the TENSION trial aimed to evaluate the incidence and predictors of ICH, including sICH and fatal ICH, in patients undergoing MT for large core ischemic stroke.Method We analyzed data from 132 patients randomized to the MT arm of the TENSION trial. ICH was assessed using the Heidelberg Bleeding Classification, and sICH was defined per SITS-MOST criteria. Baseline characteristics and procedural variables were compared between patients with and without ICH. Univariate logistic regression was used to explore associations.Results ICH occurred in 12.9% of patients, including 4.5% with sICH and 1.5% with fatal ICH. Larger infarct volumes (p=0.036) and higher numbers of thrombectomy passes (p=0.029) were significantly associated with fatal ICH. Trends toward association with sICH were observed for female sex, prolonged procedure time, and conscious sedation, while ASPECTS showed a trend toward association with any ICH.Conclusion ICH, including sICH, occurred infrequently in patients undergoing MT for large core infarcts. Larger infarcts and multiple retrieval attempts were linked to fatal ICH, but no definitive predictors for sICH emerged. These findings support the safety of MT in this high-risk population without the need for major refinements in patient selection or procedural strategies.Conflict of Interest No",
  "authors": [
    {
      "affiliations": [
        "Neuroradiology, University Hospital Heidelberg, Heidelberg, Germany"
      ],
      "name": "Sophia Hohenstatt"
    },
    {
      "affiliations": [
        "Neuroradiology, University Hospital Heidelberg, Heidelberg, Germany"
      ],
      "name": "Markus Moehlenbruch"
    },
    {
      "affiliations": [
        "Neuroradiology, University Hospital Heidelberg, Heidelberg, Germany"
      ],
      "name": "Dominik Vollherbst"
    }
  ],
  "title": "A63 Intracranial hemorrhage in patients with large core ischemic stroke in the TENSION trial – factors influencing symptomatic and any hemorrhage",
  "uid": "03e6998c-a3aa-5e97-bd1c-26a60fe4e148"
}