Abstract TMP1: Post-Interventional Contrast Staining After Endovascular Thrombectomy Does Not Influence Clinical Prognosis

Abstract

Introduction: Post-interventional contrast staining(PICS) is a common phenomenon in acute ischemic stroke (AIS) patients treated with endovascular thrombectomy(ET). Due to the small sample size in the previous studies and the limitations of image evaluation by conventional CT, determining the incidence of PICS and its consequences in AIS patients is difficult. Thus, we evaluated the incidence of PICS in AIS patients treated with ET, and its influences on functional outcome of stroke patients. Methods: 180 patients who received ET in XuanWu Hospital were analyzed retrospectively. All patients were examined by dual-energy CT (DECT) but not conventional CT within 24 h after ET. The primary outcome was the incidence of PICS. The second outcome was symptomatic ICH (sICH) according to the ECASS-III definition, as well as functional outcome assessed by modified Ranks scale (mRS), with mRS scores 0-1 indicating no disability, mRS scores 0-2 indicating functional independence and mRS scores 6 indicating death. Results: 50 of 180 patients (27.8%) had PICS in post-treatment DECT scans. We first used basic statistic analyses, showing that PICS decreased the percentage of favorable clinical prognosis in anterior circulation stroke at both 3-month (P<0.05 for mRS scores at 0-1 and 0-2) and long-term follow up of 12 (3-26.5) months (P<0.05 for mRS scores at 0-1 and 0-2). An increase in the risk of both total ICH/sICH (P<0.001) and mortality (P<0.05) in posterior circulation stroke at 3-month follow up. However, the logistic regression analyses further revealed that PICS only increased total (P<0.01) but not sICH risk. Furthermore, the logistic regression analyses did not show statistical difference in good clinical outcomes or mortality between the two groups. In the logistic regression analyses, we adjusted relative confusing factors, including age, baseline NIHSS, hypertension, DM, AF, etiology of stroke, time from onset to groin puncture, ASPECT score, pretreatment with antiplatelet or anticoagulation drugs, additional intra-arterial thrombolysis, intravenous alteplase, location of occluded arteries, sICH, and TICI scores for clinical outcomes and/or sICH. Conclusion: PICS was common in AIS patients with ET, but it did not affect functional outcome and sICH.