Computed Tomography Perfusion Parameters Predictive of Symptomatic Intracranial Hemorrhage After Mechanical Thrombectomy in Patients With Cerebral Large Vessel Occlusion

Autor: Soichiro Abe, Manabu Inoue, Manabu Shirakawa, Kazutaka Uchida, Kiyofumi Yamada, Yoji Kuramoto, Satoshi Namitome, Seigo Shindo, Fumihiro Sakakibara, Junichi Kouno, Kotaro Tatebayashi, Norito Kinjo, Shoichiro Tsuji, Shuichi Tanada, Mikiya Beppu, Hidetoshi Matsukawa, Masafumi Ihara, Shinichi Yoshimura
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: Stroke: Vascular and Interventional Neurology, Vol 3, Iss 5 (2023)
Druh dokumentu: article
ISSN: 2694-5746
DOI: 10.1161/SVIN.122.000747
Popis: Background Hemorrhagic transformation after recanalization is a severe complication in patients with a large ischemic core due to cerebral large vessel occlusion. Risk assessment using perfusion imaging to predict hemorrhagic infarction has not been established. Thus, we aimed to investigate the association between perfusion imaging findings and hemorrhagic transformation in patients with acute cerebral large vessel occlusion who had undergone preoperative perfusion imaging evaluation and mechanical thrombectomy. Methods We enrolled consecutive patients who received mechanical thrombectomy after undergoing perfusion imaging for anterior large vessel occlusion from May 2019 to March 2022. The patients in whom recanalization were not achieved and who experienced procedure‐related bleeding were excluded. We investigated the predictors of symptomatic intracranial hemorrhage (sICH) by exploring preoperative perfusion imaging parameters (relative cerebral blood flow, relative cerebral blood volume, time of maximum concentration, and hypoperfusion index ratio). Results Among the 167 patients (median age 79 years, 47% female) enrolled, 63 (38%) and 14 (8%) patients had any intracranial hemorrhage and sICH (sICH group), respectively. The sICH group had a shorter puncture‐recanalization time than the non‐sICH group (median [interquartile range (IQR)]; 43 [34–55] versus 61 [37–88]; P=0.046), whereas the modified Rankin scale at 90 days showed a worse prognosis (median [IQR]; 5 [5–6] versus 3 [1–4]; P
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