Objective To explore the influence factors of hemorrhagic transformation in the First People's Hospital of Lianyungang in patients with acute anterior circulation ischemic stroke(AIS)after mechanical thrombectomy(MT).Methods We collected the clin-ical data of 354 AIS patients who underwent MT in the Affiliated Lianyungang Hospital of Xuzhou Medical University from January 2019 to December 2023.They were grouped according to the results of cranial CT reviewed in 24-72h after the MT,and the patients who under-went HT were the HT group,with a total of 208 patients,and the patients who did not have HT were the control group,with a total of 104 patients.The clinical differences between the two groups were compared.Measurement data were analyzed using the Mann-Whitney U test,count data were analyzed using the x2 test,and multivariate Logistic regression analysis was used to identify independent risk factors.Results Compared to control group,the patients of HT group were older,had a higher prevalence of atrial fibrillation,higher preopera-tive NIHSS scores,lower platelet counts,higher glycated hemoglobin levels,and a higher proportion of preoperative thrombolytic therapy(P＜0.05).Multivariate logistic regression analysis indicated that hemoglobin(OR=1.02,95％CI:1.01-1.03,P=0.006)and glycated hemoglobin(OR=1.24,95％CI:1.09-1.40,P＜0.001)were independent influence factors for HT.Platelet count(OR=0.99,95％CI:0.99-0.99,P=0.014)was identified as a protective factor against HT.Conclusion Preoperative hemoglo-bin,glycated hemoglobin,and platelet count are all associated with HT following MT.

Objective To explore the influence factors of hemorrhagic transformation in the First People's Hospital of Lianyungang in patients with acute anterior circulation ischemic stroke(AIS)after mechanical thrombectomy(MT).Methods We collected the clin-ical data of 354 AIS patients who underwent MT in the Affiliated Lianyungang Hospital of Xuzhou Medical University from January 2019 to December 2023.They were grouped according to the results of cranial CT reviewed in 24-72h after the MT,and the patients who under-went HT were the HT group,with a total of 208 patients,and the patients who did not have HT were the control group,with a total of 104 patients.The clinical differences between the two groups were compared.Measurement data were analyzed using the Mann-Whitney U test,count data were analyzed using the x2 test,and multivariate Logistic regression analysis was used to identify independent risk factors.Results Compared to control group,the patients of HT group were older,had a higher prevalence of atrial fibrillation,higher preopera-tive NIHSS scores,lower platelet counts,higher glycated hemoglobin levels,and a higher proportion of preoperative thrombolytic therapy(P＜0.05).Multivariate logistic regression analysis indicated that hemoglobin(OR=1.02,95％CI:1.01-1.03,P=0.006)and glycated hemoglobin(OR=1.24,95％CI:1.09-1.40,P＜0.001)were independent influence factors for HT.Platelet count(OR=0.99,95％CI:0.99-0.99,P=0.014)was identified as a protective factor against HT.Conclusion Preoperative hemoglo-bin,glycated hemoglobin,and platelet count are all associated with HT following MT.

Objective To investigate the clinical application and surgical techniques of lateral-orbital keyhole approach to clip ruptured tiny aneurysms.Methods A retrospective analysis was performed on the clinical data of 56 patients with ruptured tiny aneurysms, including examination methods, imaging features, diagnosis and treatment process, and operation effect, which underwent lateral-orbital keyhole approach from January 2013 to April 2014.Results Among 56 patients with a total of 61 aneurysms(56 tiny aneurysms) was examined by CT angiography (CTA) and/or digital stubtraction angiography (DSA), all achieved successful clipping with a rupture rate of 16％(13 cases).Forty-two cases got a good recovery,8 cases owned the self-care ability, and 6 cases could carry out daily lives with help.There was no rebleeding and mortality, according to a 2-28 months' follow-up of 49 patients.Conclusion As a surgical approach for Willi'S cycle aneurysm,the lateralorbital approach is simple,rapid,minimally-invasive way.It is available in the clipping of ruptured tiny anterior communicating aneurysms.The option of operative time, perfect microdissection and exquisite intraoperative microinvasive operative skills, will be the key point of clipping aneurysms, preventing and controlling of intraoperative bleeding.