Risk factors for hemorrhagic transformation after mechanical thrombectomy in acute ischemic stroke due to anterior circulation large vessel occlusion
10.19845/j.cnki.zfysjjbzz.2025.0099
- VernacularTitle:急性颅内前循环大血管闭塞性缺血性脑卒中机械取栓术后出血转化的危险因素
- Author:
Wenyu ZHANG
1
;
Liyong ZHANG
2
Author Information
1. 山东第二医科大学临床医学院，山东 潍坊 261000
2. 聊城市人民医院神经外科，山东 聊城 252000
- Publication Type:Journal Article
- Keywords:
Acute large vessel occlusion;
Ischemic stroke;
Mechanical thrombectomy;
Hemorrhagic transformation
- From:
Journal of Apoplexy and Nervous Diseases
2025;42(6):523-528
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the potential risk factors for hemorrhagic transformation（HT）after mechanical thrombectomy（MT）in patients with acute ischemic stroke due to anterior circulation large vessel occlusion（AIS-AC-LVO），and to provide a scientific evidence for reducing post-thrombectomy HT and improving the prognosis of patients. Methods retrospective analysis was performed for the data of 605 patients with AIS-AC-LVO. The Logistic regression analysis was performed for related clinical data to identify independent predictive factors for HT after MT，with a significance threshold of P<0.05. Results A total of 605 patients were included in this study，among whom 207（34.2%）developed HT after MT，while 398（65.8%）did not experience HT. The statistical analysis showed that multiple attempts of thrombectomy（OR=1.340，P=0.003），a prolonged time of operation（OR=1.005，P=0.024），a low ASPECTS score before surgery（OR=0.798，P<0.001），postoperative mTICI≤2a（OR=6.329，P=0.032），a low platelet count before surgery（OR=0.995，P=0.008），and a high level of blood glucose before surgery（OR=1.088，P=0.009）were independent predictive factors for HT. Symptomatic intracranial hemorrhage（sICH）was observed in 68 patients（11.2%），and a history of atrial fibrillation（OR=3.151，P=0.003），a low ASPECTS score before surgery（OR=0.868，P=0.007），a prolonged time of operation（OR=1.009，P<0.001），poor collateral circulation（ASITN/SIR<2）（OR=2.307，P=0.035），a low platelet count before surgery（OR=0.993，P=0.012），a high level of D-dimer before surgery（OR=1.050，P=0.012），and a high level of blood glucose before surgery（OR=1.138，P=0.013）were independent predictive factors for sICH. Conclusion Multiple attempts of thrombectomy，a prolonged time of operation，a low ASPECTS score before surgery，postoperative mTICI≤2a，a low platelet count before surgery，and a high level of blood glucose before surgery are independent predictive factors for HT. A history of atrial fibrillation，a low ASPECTS score before surgery，a prolonged time of operation，poor collateral circulation（ASITN/SIR<2），a low platelet count before surgery，a high level of D-dimer before surgery，and a high level of blood glucose before surgery are independent predictive factors for sICH. Identifying such risk factors is crucial for reducing HT after MT and improving the efficacy of thrombectomy.
- Full text:2025071713054973776急性颅内前循环大血管闭塞性缺血性脑卒中机械取栓术后出血转化的危险因素.pdf
