Neurology: Use anticoagulant therapy with caution in patients with unruptured posterior circulation aneurysm in acute ischemic stroke

Unruptured intracranial aneurysm (UIA) is considered to be a relative contraindication for acute ischemic stroke (AIS) intravenous thrombolysis (IVT)
.

However, there are currently limited data on the risk of UIA rupture after IVT

Unruptured intracranial aneurysm (UIA) is considered to be a relative contraindication for acute ischemic stroke (AIS) intravenous thrombolysis (IVT)

Jyri Juhani Virta et al.

The study conducted a prospective cohort study of consecutive patients who were treated at comprehensive stroke centers from 2005 to 2019
.

The radiation reports and records of the Finnish Health Care Registry were evaluated to identify UIAs patients among all AIS patients who received IVT treatment at the center

The study conducted a prospective cohort study of consecutive patients who were treated at comprehensive stroke centers from 2005 to 2019

The study analyzed hospital ICH caused by UIA rupture after IVT, as well as hospital symptomatic ICHs (ECASS-2 criteria, that is, NIH stroke scale score increase ≥ 4 points) and any hospitalized ICH

Research Process

Research Process

During the 15-year study period, a total of 3953 patients received IVT treatment
.

Among 3953 AIS patients, 132 (3.

During the 15-year study period, a total of 3953 patients received IVT treatment

In all AIS patients, 18.
9% (95% CI 12.
9-26.
2%) and 8.
3% (95% CI 4.
4-13.
8%) of ICH and symptomatic ICH were detected, respectively
.

In all AIS patients, 18.
9% (95% CI 12.
9-26.
2%) and 8.
3% (95% CI 4.
4-13.
8%) of ICH and symptomatic ICH were detected, respectively
.

IVT appears to be safe (≥10 mm) in AIS patients with cystic UIAs (including large UIAs)
.

Post-AIS anticoagulation in patients with large fusiform posterior circulation UIAs may increase the risk of aneurysm rupture

IVT IVT appears to be safe (≥10 mm) in AIS patients with cystic UIAs (including large UIAs)

Virta JJ, Strbian D, Putaala J, Korja M.

Virta JJ, Strbian D, Putaala J, Korja M.
Risk of Aneurysm Rupture After Thrombolysis in Patients With Acute Ischemic Stroke and Unruptured Intracranial Aneurysms.
  Neurology .
2021;97(18):e1790-e1798.
doi:10.
1212/WNL.
0000000000012771 Virta JJ, Strbian D, J Putaala, M.
Risk of Aneurysm called Rupture Korja the After Thrombolysis in Acute Ischemic the Stroke Patients With Intracranial Aneurysms and Unruptured.
  .
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