Post-thrombolysis hemorrhage risk of unruptured intracranial aneurysms.
OBJECTIVE
It has been questioned whether patients with unruptured intracranial aneurysms (IAs) are at a greater risk for the development of intracerebral hemorrhage (ICH) following thrombolytic therapy. We thus performed a meta-analysis to better quantify the risk of post-thrombolysis ICH in patients with acute ischemic stroke and incidental IAs.


METHODS
We searched PubMed, Web of Science and EMBASE for studies assessing ICH risk in patients with acute ischemic stroke treated with thrombolysis, in relation to the presence of pretreatment IAs. A fixed-effects model meta-analysis was performed.


RESULTS
We identified four studies totaling 707 participants receiving intravenous thrombolysis. The prevalence of unruptured IAs was 6.8%. Pooled analysis demonstrates relative risk (RR) for the presence of unruptured IAs and the development of any ICH to be 1.204 (95% CI 0.709-2.043; p = 0.492; I(2) = 0.0%). The RR for sICH is 1.645 (95% CI 0.453-5.970; p = 0.449; I(2) = 28.1%).


CONCLUSIONS
Intravenous thrombolysis was safe among patients with acute ischemic stroke and incidental unruptured IAs. Future prospective studies with much larger sample sizes are required to clarify the significance of the association between pre-existing unruptured IAs and the development of post-thrombolysis ICH.
Department of Neurology, the People's Hospital of Anji, Huzhou, PR China.
Fujian
F
Chen
Shenqiang
S
Yan
Xinchun
X
Jin
Chen
C
Lin
Jin
J
Cao
D002543:Cerebral Hemorrhage / Q000139:chemically induced* / Q000453:epidemiology; D005343:Fibrinolytic Agents / Q000009:adverse effects; D006801:Humans; D002532:Intracranial Aneurysm / Q000188:drug therapy*; D011446:Prospective Studies; D012306:Risk; D015912:Thrombolytic Therapy / Q000009:adverse effects*
D005343:Fibrinolytic Agents