Yang Cheng, Sui Yong-Gang, Wang Bin-Cheng, Xu Yan-Lu, Wu Na-Qiong, Wu Yong-Jian, Li Jian-Jun, Qian Jie
Department of Cardiology, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
Diagnostics (Basel). 2023 Jul 20;13(14):2422. doi: 10.3390/diagnostics13142422.
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.
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.
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 cm. 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 ( = 0.036), intracerebral hemorrhage volume > 30 mm ( = 0.001), and intracerebral hemorrhage originating from the infratentorial origin ( = 0.044) were significantly higher in patients who died.
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.
关于经皮冠状动脉介入治疗（PCI）后颅内出血（ICH）的患病率和特征已有多篇报道，这是一种罕见但严重的并发症，死亡率很高。然而，住院患者中经计算机断层扫描（CT）确诊的有症状ICH的临床情况尚未完全明确。
在2013年至2022年期间于阜外医院接受PCI治疗的121,066例患者中，有18例在PCI术后住院期间发生了CT定义的有症状ICH。有症状ICH被定义为临床怀疑出血和/或新出现的局灶性神经体征。我们分析了ICH的发生时间、临床和影像学特征以及后续结局。
总体而言，在这项回顾性分析中，CT定义的有症状ICH的发生率为0.015%（18/12,1066）。超过一半的病例（55.6%）发生在PCI后的前12小时内。ICH患者最常见的初始表现是意识障碍。13例患者（72.2%）血肿体积≥30 cm³。此外，ICH见于脑叶（66.7%）、小脑（22.2%）以及基底节和丘脑（11.1%）。接受PCI治疗后的ICH患者90天死亡率非常高（72.2%）。死亡患者的意识障碍（P = 0.036）、脑出血体积>30 mm³（P = 0.001）以及幕下起源的脑出血（P = 0.044）明显更高。
有症状ICH事件的发生率约为0.015%，在我们接受PCI治疗的队列中短期死亡风险显著更高，这在其他队列中尚未得到证实。
