Analysis Of Risk Factors For Hemorrhagic Transformation After Endovascular Thrombectomy In Acute Anterior Circulation Large Vessel Occlusive Cerebral Infarction

Objective:To explore the independent risk factors and related effects of hemorrhage transformation after endovascular thrombus removal in acute large vessel occlusive cerebral infarction.Methods:We retrospectively analyzed the data of 102 patients with anterior circulation large vessel occlusion strokes who underwent endovascular treatment.Logistic regression analysis was performed on the data of the patients to determine the variables associated with hemorrhagic transformation(HT)or symptomatic intracranial hemorrhage(s ICH),and analyze the correlation between HT and functional prognosis at 90 days after surgery.Results :102 cases of patients with mechanical thrombectomy,intracranial hemorrhage occurred in 48 cases of conversion(47.1%),including 21 cases(20.6%)with hemorrhagic infarction(HI)and 27 cases(26.5%)with parenchymal hematoma(PH).The independent predictors of HT were the number of thrombus removals(OR =1.627,95% CI 1.134-2.334,P = 0.008),and a higher peripheral blood neutrophil to lymphocyte ratio(NLR)(OR = 1.109,95 %CI 1.007-1.220,P=0.035).17 patients(16.7%)developed s ICH in the observation team.The independent predictors of s ICH were multiple thrombus removal(OR=1.909,95% CI 1.256-2.902,P=0.002),and blood glucose level(OR=1.219,95% CI 1.019-1.458,P=0.030).In analyzing the relationship between hemorrhage transformation and functional prognosis at 90 days postoperatively,it was found that multiple thrombus removal(OR=1.671,95%CI1.026-2.722,P=0.039)and the appearance of PH(OR=8.489,95%CI 1.981-36.383,P=0.004)is an independent predictor of poor prognosis.Conclusion :Repeated thrombectomy is an independent predictor of hemorrhagic transformation(HT/s ICH)and poor 3-month functional prognosis after mechanical thrombectomy for anterior circulation large vessel occlusive cerebral infarction.Higher Neutrophil-to-lymphocyte ratio(NLR)and admission blood glucose levels is associated with the increased risk of HT,and increased blood glucose levels in hospital are closely related to s ICH after MT.In addition,substantial hematoma(PH)is independently related to functional prognosis,while hemorrhagic infarction(HI)cannot be used as an independent risk factor for functional prognosis after mechanical thrombectomy for anterior circulation large vessel occlusive cerebral infarction.