Predictors of hemorrhagic transformations after endovascular mechanical thrombectomy in patients with acute ischemic stroke

Abstract

Objective To analyze the independent risk factors for hemorrhagic transformation (HT) after endovascular mechanical thrombectomy in patients with acute ischemic stroke (AIS). Methods From March 2015 to February 2018, patients with AIS treated with mechanical thrombectomy at the Department of Neurology, TEDA Hospital were selected. The patients with hemorrhagic infarction (HI) or parenchymal hematoma (PH) were used as the case group, and those without HT were used as the control group. The independent risk factors for HI or PH after mechanical thrombectomy in patients with AIS were determined by multivariate logistic regression analysis. Results A total of 132 patients with AIS were enrolled in the study, and 60 (45.4%) developed HT, of which 37 were HI (28.03%) and 23 were PH (17.42%). Multivariate logistic regression analysis showed that after adjusting for gender, alcohol consumption, fasting blood glucose and glycated hemoglobin, diabetes (odds ratio[OR]3.485, 95% confidence interval[CI]1.121-6.928; P=0.019), atrial fibrillation (OR 3.962, 95% CI 1.143-7.514; P=0.007) and high fasting blood glucose (OR 3.254, 95% CI 1.107-6.549; P=0.036) were the independent risk factors for HI after mechanical thrombectomy in patients with AIS; after adjusting for gender, hyperlipidemia and glycosylated hemoglobin, diabetes (OR 3.348, 95% CI 1.120-6.709; P=0.025) and high fasting blood glucose (OR 3.172, 95% CI 1.129-7.023; P=0.014) were the independent risk factors for PH after mechanical thrombectomy in patients with AIS. Conclusion Diabetes, atrial fibrillation and high fasting blood glucose were the independent risk factors for HT after mechanical thrombectomy in patients with AIS. Key words: Stroke; Brain ischemia; Endovascular procedures; Thrombectomy; Cerebral hemorrhage; Diabetes mellitus; Atrial fibrillation; Risk factors