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Outcomes of antiplatelet therapy for haemorrhage patients after thrombolysis: a prospective study based on susceptibility-weighted imaging

  • Vascular and Interventional Radiology
  • Published:
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Abstract

Purpose

The authors evaluated the effect of susceptibility-weighted imaging (SWI) for antiplatelet therapy on post-thrombolysis microbleeds (MB).

Materials and methods

A total of 146 patients without symptomatic intracranial haemorrhage on computed tomography after thrombolysis were allocated to two groups: group A (n = 72) received antiplatelets 24 h after recombinant tissue plasminogen activator, regardless of SWI-detected haemorrhage; group B (n = 74) received antiplatelets for patients without SWI-visualised haemorrhage.

Results

Haemorrhage was detected by SWI in 22 and 28 patients in groups A and B, respectively. The difference in mean NIHSS (National Institutes of Health Stroke Scale) score in group A between baseline and 6, 24 h, 7, 14 days was −1.6, −1.7, −3.6, −5.9, respectively; in group B, the difference in mean NIHSS score between baseline and 6, 24 h, 7, 14 days was −2.6, −3.3, −5.4, −8.7, respectively. The difference between groups in reduction of mean NIHSS score from baseline was 1.0 (p < 0.001) at 6 h, 1.6 (p < 0.001) at 24 h, 1.8 (p = 0.001) at 7 days and 2.8 (p < 0.001) at 14 days. NIHSS scores at 7, 14 days and modified Rankin scale at 90 days were significantly lower in haemorrhage patients in groups B than in A, whereas the hospital stay was shorter and the rate of favourable outcome at 90 days was higher.

Conclusion

Our results indicated that SWI was an effective approach for the guidance of antiplatelet therapy in post-thrombolysis MB.

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Abbreviations

rt-PA:

Recombinant tissue plasminogen activator

SWI:

Susceptibility-weighted imaging

DWI:

Diffusion-weighted imaging

MB:

Microbleeds

SICH:

Symptomatic intracranial haemorrhage

HT:

Haemorrhagic transformation

PH:

Parenchymal haemorrhage

NIHSS:

National Institutes of Health Stroke Scale

mRS:

Modified Rankin scale

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Conflict of interest

Lei Yan1, Yong-Dong Li1, Yue-Hua Li1, Ming-Hua Li1, Jun-Gong Zhao1, Shi-Wen Chen2, declare that they have no conflicts of interest.

Financial Disclosure

This study has been supported by the National Natural Scientific Fund of China (Contract number: 81000609).

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Authors and Affiliations

  1. Institute of Diagnostic and Interventional Radiology, The Sixth Affiliated People’s Hospital, Shanghai Jiao Tong University, No. 600, Yi Shan Road, Shanghai, 200233, China

    Lei Yan, Yong-Dong Li, Yue-Hua Li, Ming-Hua Li & Jun-Gong Zhao

  2. Department of Neurosurgery, The Sixth Affiliated People’s Hospital, Shanghai Jiao Tong University, Shanghai, China

    Shi-Wen Chen

Authors
  1. Lei Yan
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  2. Yong-Dong Li
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  3. Yue-Hua Li
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Correspondence to Yue-Hua Li.

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Yan, L., Li, YD., Li, YH. et al. Outcomes of antiplatelet therapy for haemorrhage patients after thrombolysis: a prospective study based on susceptibility-weighted imaging. Radiol med 119, 175–182 (2014). https://doi.org/10.1007/s11547-013-0328-1

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  • DOI: https://doi.org/10.1007/s11547-013-0328-1

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