Abstract

<h3>Background</h3> Intracranial hemorrhage after endovascular thrombectomy is associated with poorer prognosis compared to those who do not develop the complication. Our study aims to determine predictors of post-EVT hemorrhage— more specifically, inflammatory biomarkers present in baseline serology. <h3>Methods</h3> We performed a retrospective review of consecutive patients treated with EVT for acute large vessel ischemic stroke. The primary outcome of the study is the presence of ICH on the post-EVT scan. We used four definitions: the SITS-MOST criteria, the NINDS criteria, asymptomatic hemorrhage and overall hemorrhage. We identified non-redundant predictors of outcome using backward elimination based on Akaike Information Criteria. We then assessed prediction accuracy using area under the receiver operating curve. Then we implemented variable importance ranking from logistic regression models using the drop in Naegelkerke R<sup>2</sup> with the exclusion of each predictor. <h3>Results</h3> Our study demonstrates a 6.3% SITS (16/252) and 10.0% NINDS (25/252) sICH rate, as well as a 19.4% asymptomatic (49/252) and 29.4% (74/252) overall hemorrhage rate. Serologic markers that demonstrated association with post-EVT hemorrhage were: low lymphocyte count (SITS), high neutrophil count (NINDS, overall hemorrhage), low platelet to lymphocyte ratio (NINDS) and low total WBC (NINDS, asymptomatic hemorrhage). <h3>Conclusion</h3> Our findings, particularly the association of diabetes mellitus and high neutrophil count with post-EVT hemorrhage, support experimental data on the role of thromboinflammation in hemorrhagic transformation of large vessel occlusions. <h3>Disclosures</h3> <b>J. Diestro:</b> None. <b>C. Parra-Farinas:</b> None. <b>M. Balas:</b> None. <b>Z. Zador:</b> None. <b>N. Almusalam:</b> None. <b>A. Dmytriw:</b> None. <b>P. Rajendram:</b> None. <b>R. Phillips:</b> None. <b>A. Alqabbani:</b> None. <b>E. Qazi:</b> None. <b>Y. Li:</b> None. <b>W. Montanera:</b> None. <b>D. Sarma:</b> None. <b>T. Marotta:</b> None. <b>A. Bharatha:</b> None. <b>J. Spears:</b> None.

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