Higher risk of symptomatic ICH after thrombectomy for acute ischemic stroke in Asian population

A recently published study from a large stroke database in China found that risk of symptomatic ICH in Asian population was higher than previous RCTs, which predominantly enrolled Caucasians. The investigators utilized data from Endovascular Treatment for Acute Anterior Circulation Ischemic Stroke Registry (ACTUAL), a multicenter registry program in China, to study the predictors for symptomatic ICH.

Of 632 enrolled patients from 2014-2016, 101 (16.0%) had symptomatic ICH within 72 hours after thrombectomy. Ninety-day mortality was higher in patients with SICH than in patients without SICH (65.3% versus 18.8%; P<0.001). The risk factors for sICH included ASPECT score< 6, multiple passes > 3, cardioembolic stroke type, and baseline neurophil ratio > 0.83. While this is a retrospective registry analysis, and endovascular treatment protocols as well as peri-operative blood pressure parameters are not standardized, the study provides important insights into the risks of endovascular intervention for an ethic group that is known to have higher risks of ischemic strokes.