{
  "abstract": "Background Functional outcomes in patients with acute ischemic stroke (AIS) with large vessel occlusion (LVO) undergoing endovascular treatment (EVT) with successful reperfusion (expanded Thrombolysis In Cerebral Infarction (eTICI) 2b-3) complicated by symptomatic intracranial hemorrhage (sICH) were compared with patients with unsuccessful reperfusion (eTICI 0–2a) without sICH.Methods Patients enrolled in this post hoc analysis were from two Chinese multicenter, randomized controlled trials: the DEVT and the RESCUE BT registries. Patients with AIS who underwent EVT were categorized into two groups according to the state of reperfusion: eTICI 2b-3 with sICH and eTICI 0–2a without sICH. The primary outcome was the modified Rankin Scale (mRS) scores at 90 days. The safety outcomes included early neurological deterioration and 90-day mortality.Results 161 patients were included in this cohort analysis, among whom 71 experienced eTICI 2b-3 with sICH, and 90 had eTICI 0–2a without sICH. After adjusting for potential confounding factors, patients in the eTICI 2b-3 with sICH group had worse mRS at 90 days compared with those in the eTICI 0–2a without sICH group in the adjusted analysis (median 6 (IQR 4–6) vs median 4 (IQR 3–6); adjusted common OR 0.39, 95% CI 0.17 to 0.66). There were also higher rates of very poor outcome (mRS 5–6, 70.4% vs 42.2%; OR 2.90, 95% CI 1.38 to 6.11), mortality (66.2% vs 32.2%; OR 0.48, 95% CI 0.30 to 0.79), and early neurological deterioration (81.7% vs 40.0%; OR 0.16, 95% CI 0.07 to 0.35) in the eTICI 2b-3 with sICH group versus the eTICI 0–2a without sICH group.Conclusions Successful reperfusion complicated by sICH after EVT was associated with worse outcomes and higher mortality than unsuccessful reperfusion without sICH. These findings emphasize the need for additional efforts in assessing and managing post-EVT-associated sICH to optimize treatment strategies and improve outcomes.Trial registration number Direct Endovascular Treatment for Large Vessel Occlusion Stroke; https://www.chictr.org.cn; ChiCTR-IOR-17013568.Intravenous Tirofiban Before Endovascular Thrombectomy for Acute Ischemic Stroke; https://www.chictr.org.cn; ChiCTR-INR-17014167.",
  "authors": [
    {
      "affiliations": [
        "Neurology, Shenqiu County People's Hospital, Shenqiu, China"
      ],
      "name": "Yanling Li"
    },
    {
      "affiliations": [
        "Neurology, The First Affiliated Hospital of Hainan Medical University, Haikou, Hainan, China"
      ],
      "name": "Yusi Fu"
    },
    {
      "affiliations": [
        "Neurology, No. 903 Hospital of PLA Joint Logistic Force, Hangzhou, Zhejiang, China"
      ],
      "name": "Xinggang Feng"
    },
    {
      "affiliations": [
        "Department of Neurology, The First People’s Hospital of Shunde, Foshan, Guangdong, China"
      ],
      "name": "Lve Chen"
    },
    {
      "affiliations": [
        "Neurology, JieYang People’s Hospital, JieYang, Guangdong, China"
      ],
      "name": "Shiwei Luo"
    },
    {
      "affiliations": [
        "neurology, Jingdezhen First People's Hospital, Jingdezhen, Jiangxi, China"
      ],
      "name": "Shunfu Jiang"
    },
    {
      "affiliations": [
        "Neurology, Zhongshan Hospital of Traditional Chinese Medicine, Zhongshan, Guangdong, China"
      ],
      "name": "Huiyuan Peng"
    },
    {
      "affiliations": [
        "Department of Neurology, The First Affiliated Hospital, Yijishan Hospital of Wannan Medical College, Wuhu, Anhui, China"
      ],
      "name": "Xianjun Huang"
    },
    {
      "affiliations": [
        "Neurology, Heyuan People's Hospital, Heyuan, Guangdong, China"
      ],
      "name": "Wensheng Zhang"
    },
    {
      "affiliations": [
        "Neurology, Houjie Hospital and Clinical College of Guangdong Medical University, Dongguan, Guangdong, China"
      ],
      "name": "Yihong Huang"
    },
    {
      "affiliations": [
        "Department of Neurology, Jiangmen Central Hospital, Jiangmen, Guangdong, China"
      ],
      "name": "Min Zhang"
    },
    {
      "affiliations": [
        "Department of Neurology, Dongguan People’s Hospital, Dongguan, Guangdong, China"
      ],
      "name": "Genpei Luo"
    },
    {
      "affiliations": [
        "Neurology, Shouguang Jitai health center, Weifang, Shandong, China"
      ],
      "name": "Fukui Ge"
    },
    {
      "affiliations": [
        "Neurology, Maanshan People's Hospital, Maanshan, Anhui, China"
      ],
      "name": "Jing Xu"
    },
    {
      "affiliations": [
        "Neurology, The People's Hospital of Gaozhou, Maoming, Guangdong, China"
      ],
      "name": "Hanning Huang"
    },
    {
      "affiliations": [
        "Neurology, Jinan University First Affiliated Hospital, Guangzhou, Guangdong, China"
      ],
      "name": "Min Guan"
    },
    {
      "affiliations": [
        "Department of Neurology, Jiangmen Central Hospital, Jiangmen, Guangdong, China"
      ],
      "name": "Zhenze Chen"
    },
    {
      "affiliations": [
        "Neurology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, Chongqing, China"
      ],
      "name": "Wenjie Zi"
    },
    {
      "affiliations": [
        "Neurology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, Chongqing, China"
      ],
      "name": "Qingwu Yang"
    },
    {
      "affiliations": [
        "Department of Neurology, Hangzhou First People's Hospital Affiliated of Westlake University School of Medicine, Hangzhou, Zhejiang, China"
      ],
      "name": "Hongfei Sang"
    },
    {
      "affiliations": [
        "Neurology, No. 903 Hospital of PLA Joint Logistic Force, Hangzhou, Zhejiang, China"
      ],
      "name": "Zhongming Qiu"
    },
    {
      "affiliations": [
        "Neurology, Huaian First People's Hospital, Huaian, Jiangsu, China"
      ],
      "name": "Mingchao Li"
    },
    {
      "affiliations": [
        "Neurology, Boston University School of Medicine, Boston, Massachusetts, USA"
      ],
      "name": "Thanh N Nguyen"
    },
    {
      "affiliations": [
        "Neurology, The First Affiliated Hospital of Hainan Medical University, Haikou, Hainan, China"
      ],
      "name": "Zhenqiang Zhao"
    },
    {
      "affiliations": [
        "Neurology, The First Affiliated Hospital of Hainan Medical University, Haikou, Hainan, China"
      ],
      "name": "Wei Li"
    }
  ],
  "title": "Successful reperfusion accompanied by symptomatic intracranial hemorrhage (sICH) versus unsuccessful reperfusion without sICH after endovascular stroke thrombectomy: a post-hoc analysis of two randomized trials",
  "uid": "e5efdc14-920d-5575-9ab9-6d939ca88556"
}