title: The Risk of Intracranial Hemorrhage in Japanese Patients with Acute Large Vessel Occlusion; subanalysis of the RESCUE-Japan registry.
abstract: BACKGROUND
  Recanalization therapies such as intravenous thrombolysis (IVT) or endovascular treatment (EVT) improve acute ischemic stroke outcomes; however, they carry the risk of intracranial hemorrhage (ICH). The present study assessed the frequency and predictive factor of ICH in Japanese patients with acute large vessel occlusion.
  
  
  METHODS
  The Recovery by Endovascular Salvage for Cerebral Ultra-acute Embolism-Japan Registry prospectively registered 1442 stroke patients with major vessel occlusion who were admitted to 84 Japanese stroke centers within 24 hours after onset, from July 2010 to June 2011. Among these 1442 patients, 1357 were included to evaluate the incidence rate and predictive factors of ICH within 24 hours after onset.
  
  
  RESULTS
  ICH was observed in 284 (20.9%) patients. Among these patients, 46 (3.4%) had symptomatic ICH, and its incidence was higher in the recanalization therapy (IVT and/or EVT) group than in the conservative therapy group (4.5% versus 2.1%, P = .013). On multivariate analyses, symptomatic ICH was related to pretreatment antiplatelet agent use and systemic heparinization, and was related to neither IVT nor EVT.
  
  
  CONCLUSIONS
  Symptomatic ICH was not affected by recanalization therapy or EVT itself in Japanese patients with acute large vessel occlusion.
authors.affiliation: Department of Neurosurgery, Graduate School of Medicine, Gifu University, Gifu, Japan. Electronic address: enomoto@gifu-u.ac.jp.
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Enomoto
authors.affiliation: Department of Neurosurgery, Hyogo Collage of Medicine, Hyogo, Japan.
authors.forename: Shinichi
authors.initials: S
authors.lastname: Yoshimura
authors.affiliation: Department of Neurosurgery, Graduate School of Medicine, Gifu University, Gifu, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Egashira
authors.affiliation: Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yamagami
authors.affiliation: Department of Neurosurgery, Kobe City Medical Center, Kobe, Japan.
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Sakai
mesh_terms: D000925:Anticoagulants / Q000009:adverse effects; D002545:Brain Ischemia / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000628:therapy*; D002539:Cerebral Arterial Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000628:therapy*; D016009:Chi-Square Distribution; D057510:Endovascular Procedures / Q000009:adverse effects; D006493:Heparin / Q000009:adverse effects; D006801:Humans; D015994:Incidence; D020300:Intracranial Hemorrhages / Q000139:chemically induced / Q000000981:diagnostic imaging / Q000453:epidemiology*; D007564:Japan / Q000453:epidemiology; D016015:Logistic Models; D015999:Multivariate Analysis; D016017:Odds Ratio; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects; D011446:Prospective Studies; D012042:Registries; D012307:Risk Factors; D020521:Stroke / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000628:therapy*; D015912:Thrombolytic Therapy / Q000009:adverse effects; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors; D006493:Heparin
keywords: Acute stroke; endovascular; intracranial hemorrhage; recanalization therapy