Why the study?
Intracranial hemorrhage after PCI is a rare but severe complication with high mortality, but the clinical landscapes of CT-confirmed, symptomatic ICH in hospitalized patients are not fully characterized.
What is the incidence, clinical characteristics, and mortality of symptomatic intracranial hemorrhage in hospitalized patients following percutaneous coronary intervention?
What is the incidence, clinical characteristics, and mortality of symptomatic intracranial hemorrhage in hospitalized patients following percutaneous coronary intervention?
Symptomatic intracranial hemorrhage following PCI is a very rare (0.015%) but highly fatal complication, with more than half of cases occurring within 12 hours post-procedure and carrying a 90-day mortality of 72.2%.
Background: There are several reports on the prevalence and characteristics of intracranial hemorrhage (ICH) following percutaneous coronary intervention (PCI), which is a rare but severe complication with high mortality. However, the clinical landscapes of computed tomography (CT)-confirmed, symptomatic ICH in hospitalized patients are not fully characterized. Methods: Among 121,066 patients receiving PCI treatment in the Fu Wai Hospital between 2013 and 2022, there were 18 CT-defined, symptomatic patients with ICH occurring during post-PCI hospitalization. Symptomatic ICH was defined as clinical suspicion of hemorrhage and/or new focal neurological signs. We analyzed ICH timing, clinical and imaging features, and subsequent outcomes. Results: Overall, in this retrospective analysis, the incidence of CT-defined, symptomatic ICH was 0.015% (18/121,066). More than half of the cases (55.6%) occurred within the first 12 h following PCI. The most common initial manifestation of ICH patients was disturbance of consciousness. Thirteen patients (72.2%) had a hematoma volume ≥ 30 cm3. Additionally, the ICH was observed in the cerebral lobe (66.7%), cerebellum (22.2%), and the basal ganglia and thalamus (11.1%). The 90-day mortality of ICH patients undergoing PCI was very high (72.2%). Consciousness disturbance (p = 0.036), intracerebral hemorrhage volume > 30 mm3 (p = 0.001), and intracerebral hemorrhage originating from the infratentorial origin (p = 0.044) were significantly higher in patients who died. Conclusions: Symptomatic ICH events occur with a rate of around 0.015%, with significantly higher short-term mortality risk in our cohort receiving PCI, which has not yet been demonstrated in other cohorts.
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Cheng et al. (2023) studied this question.
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