Article Figures & Data
Figures
- Figure 1
Case illustration. Patient with ischaemic stroke due to proximal middle cerebral artery occlusion left, the ASPECTS was 6, quantitative NWU was 17%. Patient received intravenous alteplase and underwent successful endovascular recanalisation with mTICI 2c. Symptomatic intracerebral haemorrhage occurred 24 hours after thrombectomy. NECT, non-enhanced CT; NWU, net water uptake.
- Figure 2
Flow chart of patient inclusion. NWU, net water uptake; sICH, symptomatic intracerebral haemorrhage.
- Figure 3
Multivariable logistic regression analysis to predict symptomatic intracerebral haemorrhage (sICH). Probability for sICH according to the baseline net water uptake differentiated for high versus low ASPECTS patients.
Tables
- Table 1
Patient characteristics
Baseline characteristics No ICH ICH (except sICH) sICH P value* Subjects, n (%) 56 (64) 20 (22) 12 (14) Baseline variables Age in years, median (IQR) 79 (65–86) 76 (67–83) 78 (77–83) 0.90 Female sex, n (%) 26 (47) 13 (65) 7 (58) 0.52 Arterial hypertension, n (%) 26 (46) 10 (48) 5 (40) 0.36 Cardioembolic aetiology, n (%) 35 (62) 9 (45) 5 (40) 0.14 Prior anticoagulation or antiplatelet therapy, n (%) 31 (55) 12 (60) 2 (17) 0.36 Admission NIHSS, median (IQR) 16 (9–19) 17 (13–21) 17.5 (14–20) 0.36 ASPECTS, median (IQR) 8 (7–9) 6 (5–7) 5 (5–7) <0.001 NWU, median (IQR) 9.1 (3.0–14.1) 10.3 (8.3–22.6) 18.8 (16.2–27.9) 0.007 Treatment and endpoints IVT administration, n (%) 29 (52) 16 (80) 9 (75) 0.09 mTICI 2b/3, n (%) 46 (82) 15 (77) 9 (75) 0.59 Number of passes, median (IQR) 2 (1–2) 1 (1–3) 1 (1–1) 0.62 NIHSS at 24 hours, median (IQR) 15 (8–20) 18 (11–23) 24 (19–42) 0.15 mRS 0–2, n (%) 20 (36) 3 (15) 1 (8.3) 0.008 mRS, median (IQR) 4 (2–5.5) 5 (3–6) 5.5 (3.5–6) 0.03 *Group comparison of patients with ICH versus without ICH.
ASPECTS, Alberta Stroke Program Early CT Score ; FUCT, follow-up computed tomography; ICH, intracerebral haemorrhage; IVT, intravenous thrombolysis with alteplase; mRS, modified Rankin Scale; mTICI, modified Thrombolysis In Cerebral Infarction; NIHSS, National Institute of Health Stroke Scale; NWU, net water uptake; Pr, Probability; sICH, symptomatic ICH.
- Table 2
Functional outcome and rate of symptomatic intracranial haemorrhage for patients with IVT versus without IVT according to the degree of NWU (binarised)
(A) mRS at day 90 Low NWU High NWU P value IVT 3 (IQR: 1–6) 5 (IQR: 4–6) 0.02 No IVT 3 (IQR: 2–4) 5 (IQR: 3–6) 0.01 P value 0.88 0.41 (B) % sICH IVT 0 38 0.04 No IVT 0 13 0.16 P Value 0.22 0.05 IVT, intravenous thrombolysis with alteplase; mRS, modified Rankin Scale; NWU, net water uptake; sICH, symptomatic intracerebral haemorrhage.
- Table 3
Inverse-probability weighting (IPW) analysis to show the effect of IVT, NWU and ASPECTS on sICH
sICH ATE 95% CI P value IVT (unadjusted) +12.4% −0.14 to 26.3 0.08 IVT (adjusted*) +16.8% 5.3 to 28.4 <0.01 Low ASPECTS (median) +9.8% −0.05 to 24.3 0.03 High NWU (median) +17.5% 4.9 to 30.1 <0.01 IVT in high NWU +36.1% 11.2 to 61.0 <0.01 IVT in low ASPECTS +48.2% 23.8 to 72.5 <0.001 IVT in high ASPECTS +4.9% −0.05 to 15.0 0.34 IVT in low NWU +3.4% −0.03 to 9.97 0.30 *Adjusted for age, NIHSS, NWU, ASPECTS and recanalisation status.
ASPECTS, Alberta Stroke Program Early CT Score; ATE, average treatment effect; IVT, intravenous thrombolysis with alteplase; NIHSS, National Institute of Health Stroke Scale; NWU, net water uptake; sICH, symptomatic intracerebral haemorrhage.
- Table 4
Probability for functional independence at day 90 and symptomatic intracranial haemorrhage according to the degree of baseline NWU based on multivariable logistic regression analysis
% NWU at baseline Probability for mRS 0–2* Probability for sICH* 5 29.6% 4.5% 10 27.0% 6.8% 15 24.4% 10.2% 20 22.0% 14.8% 25 19.8% 20.9% 30 17.8% 28.7% 35 15.9% 38.0% *Adjusted for age, NIHSS, ASPECTS, IVT and recanalisation status.
ASPECTS, Alberta Stroke Program Early CT Score; ICA, Internal Carotid Artery; IVT, intravenous thrombolysis with alteplase; MCA, Middle Cerebral Artery; mRS, modified Rankin Scale; NIHSS, National Institute of Health Stroke Scale; NWU, net water uptake; sICH, symptomatic intracerebral haemorrhage.
