Clinical and imaging predictors for hemorrhagic transformation of acute ischemic stroke after endovascular thrombectomy

Background and Purpose Hemorrhagic transformation (HT) is a common complication of endovascular thrombectomy (EVT) in patients with acute ischemic stroke (AIS). Our study aims to investigate the clinical and imaging predictors of HT and symptomatic intracranial hemorrhage (sICH) in patients who unde...

Full description

Saved in:

Bibliographic Details
Published in:	Journal of neuroimaging Vol. 34; no. 3; pp. 339 - 347
Main Authors:	Kuang, Yongyao, Zhang, Lingtao, Ye, Kunlin, Jiang, Zijie, Shi, Changzheng, Luo, Liangping
Format:	Journal Article
Language:	English
Published:	United States Wiley Subscription Services, Inc 01-05-2024
Subjects:	Aged Aged, 80 and over Blood flow Blood glucose Cardiovascular system Cerebral blood flow Cerebral Hemorrhage - diagnostic imaging Cerebral Hemorrhage - etiology Confidence intervals Endovascular Procedures endovascular thrombectomy Female Glucose Hemorrhage hemorrhagic transformation Humans imaging predictors Intracranial Hemorrhages - diagnostic imaging Intracranial Hemorrhages - etiology Ischemia Ischemic Stroke - diagnostic imaging Ischemic Stroke - surgery Male Medical imaging Middle Aged Multivariate analysis Postoperative Complications - diagnostic imaging Postoperative Complications - etiology Prediction models Predictions Predictive Value of Tests Regression Regression analysis Retrospective Studies Risk Factors Statistical analysis Stroke Thrombectomy endovascular thrombectomy hemorrhagic transformation stroke imaging predictors
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	Background and Purpose Hemorrhagic transformation (HT) is a common complication of endovascular thrombectomy (EVT) in patients with acute ischemic stroke (AIS). Our study aims to investigate the clinical and imaging predictors of HT and symptomatic intracranial hemorrhage (sICH) in patients who underwent EVT. Methods A retrospective analysis of 118 patients undergoing EVT for acute anterior circulation stroke was performed. Potential clinical and imaging predictors of all patients were collected and multivariate logistic regression was performed. The risk prediction system was constructed according to the multivariate logistic regression results. Results The incidence of HT and sICH after EVT were 46.6% and 15.3%, respectively. The multivariate logistic regression results showed that Alberta Stroke Program Early CT Score (ASPECTS) (p = .001, odds ratio [OR] = 0.367, 95% [confidence interval] CI, 0.201‐0.670), collateral status (p<.001, OR = 0.117, 95% CI, 0.042‐0.325), relative cerebral blood flow (CBF) ratio (p = .025, OR = 0.943, 95% CI, 0.895‐0.993), and blood glucose on admission (p = .012, OR = 1.258, 95% CI, 1.053‐1.504) were associated with HT. While for sICH, collateral circulation (p = .007, OR = 0.148, 95% CI, 0.037‐0.589), ASPECTS (p = .033, OR = 0.510, 95% CI, 0.274‐0.946), and blood glucose (p = .005, OR = 1.304, 95% CI, 1.082‐1.573) were independent factors. The predictive model for HT after EVT was established, and the sensitivity and specificity of it were 90.9% and 79.4%, respectively, with the area under the curve of 90.0% (84.5%‐95.4%). Conclusion Collateral status, ASPECTS, relative CBF ratio, and blood glucose on admission were predictors for HT in AIS patients, while collateral status, ASPECTS, and blood glucose on admission were also predictors for sICH. In addition, the established predictive model showed good diagnostic value for prediction of HT after EVT.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1051-2284 1552-6569 1552-6569
DOI:	10.1111/jon.13191