Research progress on early neurological deterioration after vascular recanalization in acute ischemic stroke

doi:10.11958/20220310

Abstract

Abstract:

Recanalization therapy has become an effective treatment for acute ischemic stroke (AIS), but due to the influence of various factors such as bleeding transformation, poor reperfusion and vascular reocclusion, some AIS patients will experience early neurological deterioration (END) after recanalization therapy, which is mainly manifested as disease progression and aggravated neurological impairment, seriously affecting the prognosis of patients. At present, there is no uniform name and diagnostic criteria for END, and results of studies on END after recanalization therapy are also different. This article reviews the pathogenesis, risk factors and predictors of END after recanalization therapy.

Key words: stroke, acute ischemic stroke, endovascular treatment, intravenous thrombolysis, early neurologic deterioration, review

CLC Number:

R743.3

References 47

[1]	WANG W, JIANG B, SUN H, et al. Prevalence,incidence,and mortality of stroke in china:Results from a nationwide population-based survey of 480 687 adults[J]. Circulation, 2017, 135(8):759-771. doi:10.1161/CIRCULATIONAHA.116.025250.
[2]	PRZYKAZA L. Understanding the connection between common stroke comorbidities,their associated inflammation,and the course of the cerebral ischemia/reperfusion cascade[J]. Front Immunol, 2021, 12:782569. doi:10.3389/fimmu.2021.782569.
[3]	POWERS W J, RABINSTEIN A A, ACKERSON T, et al. Guidelines for the early management of patients with acute ischemic stroke:2019 update to the 2018 guidelines for the early management of acute ischemic stroke:a guideline for healthcare professionals from the american heart association/american stroke association[J]. Stroke, 2019, 50(12):e344-e418. doi:10.1161/STR.0000000000000211.
[4]	LEE V H, THAKUR G, NIMJEE S M, et al. Early neurologic decline in acute ischemic stroke patients receiving thrombolysis with large vessel occlusion and mild deficits[J]. J Neurointerv Surg, 2020, 12(11):1085-1087. doi:10.1136/neurintsurg-2020-015871.
[5]	HSU C Y, CHENG C Y, TSAI Y H, et al. Perfusion-diffusion mismatch predicts early neurological deterioration in anterior circulation infarction without thrombolysis[J]. Curr Neurovasc Res, 2015, 12(3):277-282. doi:10.2174/1567202612666150605122536.
[6]	VAN KRANENDONK K R, TREURNIET K M, BOERS A M M, et al. Hemorrhagic transformation is associated with poor functional outcome in patients with acute ischemic stroke due to a large vessel occlusion[J]. J Neurointerv Surg, 2019, 11(5):464-468. doi:10.1136/neurintsurg-2018-014141.
[7]	HAO Y, LIU W, WANG H, et al. Prognosis of asymptomatic intracranial hemorrhage after endovascular treatment[J]. J Neurointerv Surg, 2019, 11(2):123-126. doi:10.1136/neurintsurg-2018-013848.
[8]	KIM J S, KIM Y J, LEE K B, et al. Low- versus standard-dose intravenous alteplase in the context of bridging therapy for acute ischemic stroke:a Korean ENCHANTED study[J]. J Stroke, 2018, 20(1):131-139. doi:10.5853/jos.2017.01578.
[9]	ARBA F, PICCARDI B, PALUMBO V, et al. Blood-brain barrier leakage and hemorrhagic transformation:the reperfusion injury in ischemic stroke (RISK) study[J]. Eur J Neurol, 2021, 28(9):3147-3154. doi:10.1111/ene.14985.
[10]	LIU X, DAI Q, YE R, et al. Endovascular treatment versus standard medical treatment for vertebrobasilar artery occlusion (BEST):an open-label,randomised controlled trial[J]. Lancet Neurol, 2020, 19(2):115-122. doi:10.1016/s1474-4422(19)30395-3.
[11]	GIROT J B, RICHARD S, GARIEL F, et al. Predictors of unexplained early neurological deterioration after endovascular treatment for acute ischemic stroke[J]. Stroke, 2020, 51(10):2943-2950. doi:10.1161/STROKEAHA.120.02949.
[12]	FABRITIUS M P, WOLFER T A, HERZBERG M, et al. Course of early neurologic symptom severity after endovascular treatment of anterior circulation large vessel occlusion stroke:association with baseline multiparametric CT imaging and clinical parameters[J]. Diagnostics(Basel), 2021, 11(7):1272. doi:10.3390/diagnostics11071272.
[13]	WONG G J, YOO B, LIEBESKIND D, et al. Frequency,determinants,and outcomes of emboli to distal and new territories related to mechanical thrombectomy for acute ischemic stroke[J]. Stroke, 2021, 52(7):2241-2249. doi:10.1161/STROKEAHA.120.033377.
[14]	WELCH J C, ERKMEN K, GENTILE N. Changes in procoagulant blood biomarkers after mechanical thrombectomy[J]. J Stroke Cerebrovasc Dis, 2021, 30(6):105772. doi:10.1016/j.jstrokecerebrovasdis.2021.105772.
[15]	MARTO J P, STRAMBO D, HAJDU S D, et al. Twenty-four-hour reocclusion after successful mechanical thrombectomy:associated factors and long-term prognosis[J]. Stroke, 2019, 50(10):2960-2963. doi:10.1161/STROKEAHA.119.026228.
[16]	BRONDANI R, DE ALMEIDA A G, CHERUBINI P A, et al. Risk factors for epilepsy after thrombolysis for ischemic stroke:a cohort study[J]. Front Neurol, 2019, 10:1256. doi:10.3389/fneur.2019.01256.
[17]	BRIGO F, SCHNEIDER M, WAGENPFEIL G, et al. Intravenous thrombolysis with tPA and cortical involvement increase the risk of early poststroke seizures:results of a case-control study[J]. Epilepsy Behav, 2020, 104(Pt B):106312. doi:10.1016/j.yebeh.2019.04.056.
[18]	MOHAMMADEN M H, STAPLETON C J, BRUNOZZI D, et al. Risk factors for distal clot migration during mechanical thrombectomy of anterior circulation large vessel occlusion[J]. Cerebrovasc Dis, 2020, 49(2):185-191. doi:10.1159/000507341.
[19]	AWADH M, MACDOUGALL N, SANTOSH C, et al. Early recurrent ischemic stroke complicating intravenous thrombolysis for stroke:incidence and association with atrial fibrillation[J]. Stroke, 2010, 41(9):1990-1995. doi:10.1161/STROKEAHA.109.569459.
[20]	STEFFEL J, VERHAMME P, POTPARA T S, et al. The 2018 European heart rhythm association practical guide on the use of non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation[J]. Eur Heart J, 2018, 39(16):1330-1393. doi:10.1093/eurheartj/ehy136.
[21]	WU H M, LEE I H, LUO C B, et al. Clinical-CT mismatch defined NIHSS ≥8 and CT-ASPECTS ≥9 as a reliable marker of candidacy for intravenous thrombolytic therapy in acute ischemic stroke[J]. PLoS One, 2021, 16(4):e0251077. doi:10.1371/journal.pone.0251077.
[22]	PISTOCCHI S, STRAMBO D, BARTOLINI B, et al. MRI software for diffusion-perfusion mismatch analysis may impact on patients' selection and clinical outcome[J]. Eur Radiol, 2022, 32(2):1144-1153. doi:10.1007/s00330-021-08211-2.
[23]	GAWLITZA M, GRAGERT J, QUÄSCHLING U, et al. FLAIR-hyperintense vessel sign,diffusion-perfusion mismatch and infarct growth in acute ischemic stroke without vascular recanalisation therapy[J]. J Neuroradiol, 2014, 41(4):227-233. doi:10.1016/j.neurad.2013.10.004.
[24]	DENG P P, WU N, CHEN X J, et al. NIHSS-the Alberta Stroke Program Early CT Score mismatch in guiding thrombolysis in patients with acute ischemic stroke[J]. J Neurol, 2022, 269(3):1515-1521. doi:10.1007/s00415-021-10704-5.
[25]	KIM B J, LEE Y, KWON B, et al. Clinical-diffusion mismatch is associated with early neurological improvement after late-window endovascular treatment[J]. Cerebrovasc Dis, 2022, 51(3):331-337. doi:10.1159/000519310.
[26]	ALAWNEH J A, JONES P S, MIKKELSEN I K, et al. Infarction of 'non-core-non-penumbral' tissue after stroke:multivariate modelling of clinical impact[J]. Brain, 2011, 134(Pt 6):1765-1776. doi:10.1093/brain/awr100.
[27]	SUN H, LIU Y, GONG P, et al. Intravenous thrombolysis for ischemic stroke with hyperdense middle cerebral artery sign:a Meta-analysis[J]. Acta Neurol Scand, 2020, 141(3):193-201. doi:10.1111/ane.13177.
[28]	DARCOURT J, GARCIA C, PHUONG D M, et al. Absence of susceptibility vessel sign is associated with aspiration-resistant fibrin/platelet-rich thrombi[J]. Int J Stroke, 2021, 16(8):972-980. doi:10.1177/1747493020986626.
[29]	KONERU S, NOGUEIRA R G, OSEHOBO E, et al. Clot composition in retrieved thrombi after mechanical thrombectomy in strokes due to carotid web[J]. J Neurointerv Surg, 2021, 13(6):530-533. doi:10.1136/neurintsurg-2020-017112.
[30]	BELACHEW N F, DOBROCKY T, ALEMAN E B, et al. SWI susceptibility vessel sign in patients undergoing mechanical thrombectomy for acute ischemic stroke[J]. AJNR Am J Neuroradiol, 2021, 42(11):1949-1955. doi:10.3174/ajnr.A7281.
[31]	MEREUTA O M, FITZGERALD S, CHRISTENSEN T A, et al. High-resolution scanning electron microscopy for the analysis of three-dimensional ultrastructure of clots in acute ischemic stroke[J]. J Neurointerv Surg, 2021, 13(10):906-911. doi:10.1136/neurintsurg-2020-016709.
[32]	BRINJIKJI W, MADALINA MEREUTA O, DAI D, et al. Mechanisms of fibrinolysis resistance and potential targets for thrombolysis in acute ischaemic stroke:lessons from retrieved stroke emboli[J]. Stroke Vasc Neurol, 2021, 6(4):658-667. doi:10.1136/svn-2021-001032.
[33]	ABBASI M, KVAMME P, LAYTON K F, et al. Per pass analysis of thrombus composition retrieved by mechanical thrombectomy[J]. Interv Neuroradiol, 2021, 27(6):815-820. doi:10.1177/15910199211009119.
[34]	OIS A, MARTINEZ-RODRIGUEZ J E, MUNTEIS E, et al. Steno-occlusive arterial disease and early neurological deterioration in acute ischemic stroke[J]. Cerebrovasc Dis, 2008, 25(1/2):151-156. doi:10.1159/000113732.
[35]	CHANG J Y, KIM W J, KWON J H, et al. Prestroke glucose control and functional outcome in patients with acute large vessel occlusive stroke and diabetes after thrombectomy[J]. Diabetes Care, 2021, 44(9):2140-2148. doi:10.2337/dc21-0271.
[36]	MAZIGHI M, RICHARD S, LAPERGUE B, et al. Safety and efficacy of intensive blood pressure lowering after successful endovascular therapy in acute ischaemic stroke (BP-TARGET):a multicentre,open-label,randomised controlled trial[J]. Lancet Neurol, 2021, 20(4):265-274. doi:10.1016/S1474-4422(20)30483-X.
[37]	FAN K, ZHAO J, CHANG H, et al. Predicting prognosis in patients with stroke treated with intravenous alteplase through the 24-h trajectory of blood pressure changes[J]. J Clin Hypertens (Greenwich), 2021, 23(9):1718-1730. doi:10.1111/jch.14331.
[38]	ANADANI M, ARTHUR A S, ALAWIEH A, et al. Blood pressure reduction and outcome after endovascular therapy with successful reperfusion:a multicenter study[J]. J Neurointerv Surg, 2020, 12(10):932-936. doi:10.1136/neurintsurg-2019-015561.
[39]	ANADANI M, ARTHUR A S, TSIVGOULIS G, et al. Blood pressure goals and clinical outcomes after successful endovascular therapy:a multicenter study[J]. Ann Neurol, 2020, 87(6):830-839. doi:10.1002/ana.25716.
[40]	SUN D, TONG X, HUO X, et al. Unexplained early neurological deterioration after endovascular treatment for acute large vessel occlusion:incidence,predictors,and clinical impact:data from ANGEL-ACT registry[J]. J Neurointerv Surg, 2022, 14(9):875-880. doi:10.1136/neurintsurg-2021-017956.
[41]	CHOI D W. Excitotoxicity:still hammering the ischemic brain in 2020[J]. Front Neurosci, 2020, 14:579953. doi:10.3389/fnins.2020.579953.
[42]	MARTIN A J, PRICE C I. A systematic review and meta-analysis of molecular biomarkers associated with early neurological deterioration following acute stroke[J]. Cerebrovasc Dis, 2018, 46(5/6):230-241. doi:10.1159/000495572.
[43]	HUO L, CHEN P, WANG Z, et al. Impact of leukoaraiosis severity on the association of outcomes of mechanical thrombectomy for acute ischemic stroke:a systematic review and a meta-analysis[J]. J Neurol, 2021, 268(11):4108-4116. doi:10.1007/s00415-020-10167-0.
[44]	BROOCKS G, KNIEP H, KEMMLING A, et al. Effect of intravenous alteplase on ischaemic lesion water homeostasis[J]. Eur J Neurol, 2020, 27(2):376-383. doi:10.1111/ene.14088.
[45]	CHOI K H, KIM J M, KIM J H, et al. Optimal blood pressure after reperfusion therapy in patients with acute ischemic stroke[J]. Sci Rep, 2019, 9(1):5681. doi:10.1038/s41598-019-42240-8.
[46]	JANG S H, SOHN S I, PARK H, et al. The safety of intra-arterial tirofiban during endovascular therapy after intravenous thrombolysis[J]. AJNR Am J Neuroradiol, 2021, 42(9):1633-1637. doi:10.3174/ajnr.A7203.
[47]	WANG Y, WU X, ZHU C, et al. Bridging thrombolysis achieved better outcomes than direct thrombectomy after large vessel occlusion:an updated meta-analysis[J]. Stroke, 2021, 52(1):356-365. doi:10.1161/STROKEAHA.120.031477.