Abstract WP213: Exploring Contrast Extravasation and Associated Variables in Acute Ischemic Stroke Patients After Mechanical Thrombectomy: Single Center Experience

Abstract

Introduction: Head CT hyperdensity (HCH) commonly follows mechanical thrombectomy (MT) for large vessel occlusion (LVO), often due to contrast extravasation (CE) or intracerebral hemorrhage (ICH). Given the 20-88% prevalence in studies, understanding associated variables is crucial for outcomes. Risk factors for ICH after MT are studied, but CE understanding is lacking. We investigated CE occurrence variables and their impact on outcomes. Methods: We retrospectively analyzed data from 164 patients (mean age 65 years, 51% men, 59% White) with LVO who underwent MT in our center (between 2019-2022) with initial and repeat post-MT CT scans within a 24-hour window. CE was defined as the disappearance or reduction of HCH on repeat CT within 24 hours; those with both CE and ICH were excluded. We investigated demographic information, risk factors, lab values, procedural, and neurological outcome data. Parametric and non-parametric tests compared variables between CE and ICH. Adjusted odds ratios (aOR) were computed through multivariate logistic regression to evaluate the association of CE with the variables. Results: HCH was reported in 56.1% (92 out of 164) of patients in our cohort. CE and ICH were detected in 34 (20.4%) and 58 (35.4%) patients. In unadjusted models, our patients with CE had higher low-density lipoprotein (LDL) levels (111 mg/dL vs. 80 mg/dL, p=0.04) and lower complete reperfusion score (29.4% vs. 55.2%, p=0.02) (Table 1). Multivariate logistic regression analysis demonstrated a higher aOR (1.03, 95%CI 1-1.06, p=0.03) of LDL in patients with CE (Table 2). Conclusion: Our findings revealed a notable association between CE and higher LDL levels. Elevated LDL levels are often linked to systemic inflammation, endothelial dysfunction, vascular changes, and disruptions in the blood-brain barrier, increasing the likelihood of CE. This association prompts further investigation into the underlying pathophysiology of CE.