White matter lesion effect modification of aspirin and unfractionated heparin during endovascular stroke treatment.

ABSTRACT:

Objectives

Periprocedural aspirin or unfractionated heparin during endovascular treatment in acute ischemic stroke increases symptomatic intracranial hemorrhage (sICH) risk without improving functional outcome. White matter lesions (WMLs) are associated with higher sICH risk and poor functional outcome following stroke. We aimed to assess whether WML volume modifies the effect of aspirin or heparin.

Materials and methods

In this post-hoc analysis of the MR CLEAN-MED trial, WML volume was automatically determined using deep learning-based segmentation on baseline non-contrast CT scans. Outcomes included good functional outcome (modified Rankin Scale 0-2 at 90 days), any ICH, asymptomatic ICH (aICH), and sICH. Patients received either aspirin or not, and either heparin or not.

SUBMITTER: van Poppel LM 

PROVIDER: S-EPMC12546164 | biostudies-literature | 2025 Oct

REPOSITORIES: biostudies-literature