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• CLINICAL ARTICLE •
Predictors of intracranial hemorrhage after mechanical thrombectomy in acute ischemic stroke
WANG Rui  PENG Mingyang  ZHOU Xingfan  YIN Xindao  WANG Tongxing 

Cite this article as: Wang R, Peng MY, Zhou XF, et al. Predictors of intracranial hemorrhage after mechanical thrombectomy in acute ischemic stroke[J]. Chin J Magn Reson Imaging, 2021, 12(1): 9-14. DOI:10.12015/issn.1674-8034.2021.01.003.


[Abstract] Objective To investigate the predictors for the occurrence of intracranial hemorrhage (ICH) in acute ischemic stroke patients after mechanical thrombectomy (MT).Materials and Methods In this retrospective study, one hundred and thirty-five acute stroke patients who were treated in our hospital from January 2017 to June 2019 were evaluated. All patients underwent MR examination after MT therapy. ICH was evaluated by brain CT or MR examination after MT within 24 hours. ICH was divided into symptomatic ICH (sICH) and non-sICH (patients without ICH and sICH). MRI data and other clinical data were recorded. Statistical methods were used to analyze the predictors of ICH and sICH after MT in acute ischemic stroke.Results Compared with no ICH group (n=79), ICH group (n=56) had higher fasting blood glucose (129.08±18.87 vs 139.77±16.70), higher glycated hemoglobin (HbA1c) (5.57±0.34 vs 5.99±0.42) and larger DWI infarct volume (20.28±26.30 vs 5.99±0.42), there were significant differences between two groups (t=-7.974, P＜0.001; t=-6.421, P＜0.001; t=-2.970, P=0.004). The DWI infarct volume in sICH group (n=18) (52.21±50.23) was larger than that in non-sICH (n=117) (24.28±29.99), the difference was statistically significant (t=-3.317; P=0.001). Spearman correlation analysis showed that fasting blood glucose (r=0.554; P＜0.001), HbA1c (r=0.450; P＜0.001) and larger DWI infarct volume (r=0.309; P＜0.001) were positively correlated with ICH, DWI infarct volume (r=0.234; P=0.006) was positively correlated with sICH. Logistic regression analysis showed that fasting blood glucose [OR (95% CI): 1.233 (1.139─1.335), P＜0.001], HbA1c [OR (95% CI): 39.121 (7.537─203.052), P＜0.001] and larger DWI infarct volume [OR (95% CI): 1.025 (1.006─1.044), P=0.009] were independent predictors of ICH after MT; DWI infarct volume [OR (95% CI): 1.018 (1.006─1.030), P=0.004] were independent predictors of sICH after MT.Conclusions Comprehensive evaluation of fasting blood glucose, HbA1c and DWI infarct volume can effectively predict the occurrence of ICH and sICH after MT, and guide clinical individualized treatment and improve functional outcome.
[Keywords] acute ischemic stroke；mechanical thrombectomy；intracranial hemorrhage；magnetic resonance imaging；predictors

WANG Rui1   PENG Mingyang2   ZHOU Xingfan2   YIN Xindao2   WANG Tongxing2*  

1 Department of Radiology, Nanjing Integrated Traditional Chinese And Western Medicine Hospital, Nanjing 210014, China

2 Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China

*Corresponding author: Wang TX, E-mail: txking@126.com

Conflicts of interest   None.

ACKNOWLEDGMENTS  This article is supported by the Jiangsu Science and Technology Development Project No. BE2017614 and the Medical and Health Research Project of Nanjing Health and Family Planning Commission No. YKK18101
Received  2020-08-21
Accepted  2020-11-28
DOI: 10.12015/issn.1674-8034.2021.01.003
Cite this article as: Wang R, Peng MY, Zhou XF, et al. Predictors of intracranial hemorrhage after mechanical thrombectomy in acute ischemic stroke[J]. Chin J Magn Reson Imaging, 2021, 12(1): 9-14. DOI:10.12015/issn.1674-8034.2021.01.003.

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