Journal of Neurosurgical Sciences 2020 Dec 15

DOI: 10.23736/S0390-5616.20.05141-3

Copyright © 2020 EDIZIONI MINERVA MEDICA

language: English

Risk factors and functional outcome were associated with hemorrhagic transformation after mechanical thrombectomy for acute large vessel occlusion stroke

Weirong LI, Xiaolian XING, Chao WEN, Hongwei LIU ✉

Department of Neurology, Tai yuan Central Hospital, Shanxi Medical University, Taiyuan, Shanxi Province, China

BACKGROUND: Risk factors and functional outcome of hemorrhagic transformation (HT) after mechanical thrombectomy (MT) are to be elucidated in paitents with acute large vessel occlusion stroke.
METHODS: We retrospectively analyzed data from 88 patients who underwent MT treatment. Independent risk factors of hemorrhagic infarction (HI), parenchymal hematoma (PH) and symptomatic intracranial hemorrhage (sICH) were implemented to determine. Association between HI, PH, sICH and mortality at 90 days after treatment were analyzed.
RESULTS: Of 88 patients, 44.3%had HT(n=39). 64.1% had HI (n=25), 35.9% had PH(n=14) and 12.5% had sICH (n=11). Independent risk factors for HI were associated with higher NIHSS score (OR,1.190;95% CI,1.073~1.319,P=0.001,per 1 score increase) , history of coronary heart disease (OR,4.645;95% CI,1.092~19.758,P=0.038),and use of intravenous thrombolysis (OR,3.438;95% CI,1.029~11.483,P=0.045). Independent risk factors for PH were associated with higher NIHSS score (OR,1.227;95% CI,1.085~1.387,P=0.001,per 1 score increase) and history of oral anti-platelet and/or anticoagulation drugs (OR,6.694;95% CI,1.245~35.977,P=0.027). Independent risk factors for sICH were associated with higher NIHSS score (OR,1.393;95% CI,1.138~1.704,P=0.001,per 1 score increase), increased systolic blood pressure (OR,1.061;95% CI,1.006~1.120,P=0.030,per 1 mmHg increase) and history of coronary heart disease (OR,13.699;95% CI,1.019~184.098,P=0.048). Patients who had PH were more likely to cause mortality at 90 days (OR,10.15;95%CI,1.455~70.914,P=0.019).
CONCLUSIONS: Higher NIHSS score was associated with HI, PH and sICH. History of coronary heart was associated with HI and sICH. Use of intravenous thrombolysis was associated with HI. History of oral anti-platelet and/or anti-coagulation drugs was associated with PH. Increased systolic blood pressure was associated with sICH. PHs was remarkablely associated with mortality at 90 days.

KEY WORDS: Acute ischemic stroke; Mechanical thrombectomy; Hemorrhagic infarction; Parenchymal hematoma; Symptomatic intracranial hemorrhage