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

IF 2.3 4区医学 Q3 CLINICAL NEUROLOGY Journal of Neuroimaging Pub Date : 2024-01-31 DOI:10.1111/jon.13191

Yongyao Kuang, Lingtao Zhang, Kunlin Ye, Zijie Jiang, Changzheng Shi, Liangping Luo

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Abstract

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.

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血管内血栓切除术后急性缺血性脑卒中出血转化的临床和影像学预测因素。

背景和目的：出血转化（HT）是急性缺血性卒中（AIS）患者血管内血栓切除术（EVT）的常见并发症。我们的研究旨在调查接受 EVT 患者发生 HT 和症状性颅内出血（sICH）的临床和影像学预测因素：方法：我们对118例因急性前循环卒中接受EVT治疗的患者进行了回顾性分析。收集了所有患者的潜在临床和影像学预测因素，并进行了多变量逻辑回归。根据多变量逻辑回归结果构建了风险预测系统：EVT术后HT和sICH的发生率分别为46.6%和15.3%。多变量逻辑回归结果显示，阿尔伯塔省卒中项目早期 CT 评分（ASPECTS）（p = .001，几率比[OR] = 0.367，95% [置信区间] CI，0.201-0.670）、侧支状态（p结论：侧支状态、ASPECTS 评分、多变量逻辑回归结果显示，EVT 后的 HT 和 sICH 发生率分别为 46.6% 和 15.3%：侧支状态、ASPECTS、相对 CBF 比率和入院时的血糖是 AIS 患者发生 HT 的预测因素，而侧支状态、ASPECTS 和入院时的血糖也是发生 sICH 的预测因素。此外，已建立的预测模型对预测 EVT 后的 HT 有很好的诊断价值。

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来源期刊

Journal of Neuroimaging 医学-核医学

CiteScore

4.70

自引率

0.00%

发文量

117

审稿时长

6-12 weeks

期刊介绍： Start reading the Journal of Neuroimaging to learn the latest neurological imaging techniques. The peer-reviewed research is written in a practical clinical context, giving you the information you need on: MRI CT Carotid Ultrasound and TCD SPECT PET Endovascular Surgical Neuroradiology Functional MRI Xenon CT and other new and upcoming neuroscientific modalities.The Journal of Neuroimaging addresses the full spectrum of human nervous system disease, including stroke, neoplasia, degenerating and demyelinating disease, epilepsy, tumors, lesions, infectious disease, cerebral vascular arterial diseases, toxic-metabolic disease, psychoses, dementias, heredo-familial disease, and trauma.Offering original research, review articles, case reports, neuroimaging CPCs, and evaluations of instruments and technology relevant to the nervous system, the Journal of Neuroimaging focuses on useful clinical developments and applications, tested techniques and interpretations, patient care, diagnostics, and therapeutics. Start reading today!