{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,23]],"date-time":"2026-05-23T10:06:25Z","timestamp":1779530785537,"version":"3.53.1"},"reference-count":24,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T00:00:00Z","timestamp":1764028800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"The New South Wales (NSW) Cardiovascular Elite Postdoctoral Researcher Grant","award":["H23\/15813"],"award-info":[{"award-number":["H23\/15813"]}]},{"DOI":"10.13039\/501100003593","name":"The Ministry of Health and the National Council for Scientific and Technological Development of Brazil","doi-asserted-by":"publisher","award":["CNPQ: 467322\/2014-7, 402388\/2013-5"],"award-info":[{"award-number":["CNPQ: 467322\/2014-7, 402388\/2013-5"]}],"id":[{"id":"10.13039\/501100003593","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000925","name":"The National Health and Medical Research Council (NHMRC) of Australia","doi-asserted-by":"publisher","award":["1020462 and 1101113"],"award-info":[{"award-number":["1020462 and 1101113"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"name":"The Ministry for Health, Welfare and Family Affairs of the Republic of Korea","award":["HI14C1985"],"award-info":[{"award-number":["HI14C1985"]}]},{"name":"The Stroke Association of the UK","award":["TSA 2012\/01 and 2015\/01"],"award-info":[{"award-number":["TSA 2012\/01 and 2015\/01"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["International Journal of Stroke"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To determine associations between cerebral microbleeds (CMBs) and intracerebral hemorrhage (ICH) as well as functional recovery after thrombolysis in participants of the Enhanced Control of Hypertension and Thrombolysis Stroke Study (ENCHANTED).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>ENCHANTED recruited acute ischemic stroke (AIS) patients eligible for thrombolytic therapy from 111 clinical centers in 13 countries. We included those with T2*-weighted or susceptibility-weighted brain magnetic resonance imaging within 6\u2009h after AIS. Associations between CMB (primary predictor), burden (0, 1, 2\u20134, or \u2a7e5 CMBs), and location (deep, lobar, mixed) and any ICH (primary outcome), symptomatic intracerebral hemorrhage (sICH), 90-day disability or death (modified Rankin scale (mRS) score 2\u20136), and other unfavorable functional outcomes (mRS 3\u20136, 6, and shift) were explored in logistic regression models and in a stratification by alteplase dose.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Of 311 eligible AIS participants, 111 (35.7%) had CMB(s) and this was not associated with an increase in any ICH (adjusted odds ratio = 1.49, 95% confidence interval (CI) = 0.87\u20132.54) or sICH (2.05, 0.92\u20134.56). However, the presence of CMB(s) was associated with 90-day disability or death (1.75, 1.04\u20132.94) and other unfavorable functional outcomes. Comparable associations were seen between CMB burden (defined as ordinally categorical; any ICH 1.16 (0.90\u20131.50), mRS 2\u20136 1.44 (1.11\u20131.87)) or mixed deep-lobar distribution (any ICH 1.42 (0.61\u20133.29), mRS 2\u20136 3.66 (1.48\u20139.05)) and these outcomes. There were no differences in associations between CMB presence\/burden\/distribution and outcomes between two different alteplase doses (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      <jats:sub>interaction<\/jats:sub>\n                      \u2009&gt;\u20090.087).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>In ENCHANTED, CMB(s) was associated with 90-day unfavorable function recovery but not with a significantly increased likelihood of ICH in post-intravenous thrombolytic AIS. Low-dose alteplase may not offer a better profile for AIS with CMB(s).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data access statement:<\/jats:title>\n                    <jats:p>Individual de-identified participant data used in this analysis will be shared by request from any qualified investigator via the Research Office of The George Institute for Global Health.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17474930251392751","type":"journal-article","created":{"date-parts":[[2025,10,24]],"date-time":"2025-10-24T04:07:03Z","timestamp":1761278823000},"page":"657-666","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Intravenous thrombolysis in patients with acute ischemic stroke and cerebral microbleeds: Results from the ENCHANTED trial"],"prefix":"10.1177","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6543-7113","authenticated-orcid":false,"given":"Zien","family":"Zhou","sequence":"first","affiliation":[{"name":"The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yilun","family":"Ge","sequence":"additional","affiliation":[{"name":"The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia"},{"name":"Department of Neurology, The Second Affiliated Hospital of Soochow University, Suzhou, PR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sohei","family":"Yoshimura","sequence":"additional","affiliation":[{"name":"Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takako","family":"Torii-Yoshimura","sequence":"additional","affiliation":[{"name":"Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan"},{"name":"Department of Neurology and Neuroscience, Graduate School of Medical Sciences and Medical School, Nagoya City University, Nagoya, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8353-1787","authenticated-orcid":false,"given":"Yuki","family":"Sakamoto","sequence":"additional","affiliation":[{"name":"Department of Neurology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoqiu","family":"Liu","sequence":"additional","affiliation":[{"name":"The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8942-953X","authenticated-orcid":false,"given":"Cheryl","family":"Carcel","sequence":"additional","affiliation":[{"name":"The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8367-542X","authenticated-orcid":false,"given":"Xiaoying","family":"Chen","sequence":"additional","affiliation":[{"name":"The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leibo","family":"Liu","sequence":"additional","affiliation":[{"name":"The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Parsons","sequence":"additional","affiliation":[{"name":"South Western Sydney Clinical School, University of New South Wales, Sydney, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grant","family":"Mair","sequence":"additional","affiliation":[{"name":"Edinburgh Imaging, Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0104-5679","authenticated-orcid":false,"given":"Richard I","family":"Lindley","sequence":"additional","affiliation":[{"name":"Sydney Medical School, University of Sydney, Sydney, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9812-6642","authenticated-orcid":false,"given":"Joanna","family":"Wardlaw","sequence":"additional","affiliation":[{"name":"Edinburgh Imaging, Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, UK"},{"name":"UK Dementia Research Institute, The University of Edinburgh, Edinburgh, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Craig S","family":"Anderson","sequence":"additional","affiliation":[{"name":"The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia"},{"name":"Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, PR China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2257-4286","authenticated-orcid":false,"given":"Candice","family":"Delcourt","sequence":"additional","affiliation":[{"name":"The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia"},{"name":"Department of Clinical Medicine, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,11,25]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2016.0292"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.116.012992"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-018-9156-5"},{"key":"e_1_3_2_5_2","doi-asserted-by":"crossref","DOI":"10.1161\/STR.0000000000000211","article-title":"Guidelines for the early management of patients with acute ischemic stroke: 2019 update to the 2018 guidelines for the early management of acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association\/American Stroke Association","volume":"50","author":"Powers WJ","year":"2019","unstructured":"Powers WJ, Rabinstein AA, Ackerson T, et al. Guidelines for the early management of patients with acute ischemic stroke: 2019 update to the 2018 guidelines for the early management of acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association\/American Stroke Association. 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