Relationship Beuveen Clot Burden Score And Intracranial Hemontiage Transformation Of Acute Ischemic Stroke After Endox Ascular Treatment

Objective:Intracranial hemorrhage is one of major complications following endovascular treatment in patients with acute ischemic stroke.We aimed to investigate the relationship between the clot burden score(CBS)and the intracranial hemorrhage transformation after treatment.Methods:Our study was a single-center retrospective study which included 86 patients from January 2018 to October 2019 who underwent endovascular treatment because of large artery occlusion in the anterior circulation.Any intracranial hemorrhage observed on 24-hour follow-up imaging was the primary outcome.Symptomatic intracranial hemorrhage and clinical outcomes at 90 days after endovascular treatment were the secondary outcomes.We used univariate analysis and multivariate logistic regression to investigate the relationship between intracranial hemorrhage transformation and clot burden score.Results:Of the 86 enrolled patients,27(31.4%)patients were diagnosed with intracranial hemorrhage at 24 hours after endovascular treatment.Symptomatic hemorrhage was observed in 11(12.8%)patients.Univariate analysis showed that there were statistically significant differences between the six factors including atrial fibrillation and clot burden score in the hemorrhagic and non-hemorrhagic transformation groups(P<0.05).On multivariable analysis,clot burden score<6(odds ratio[OR],4.256;95%confidence interval[CI],1.098-16.487,p=0.036),poor collateral status(OR,13.399;95%CI,1.949-92.133,p=0.008),atrial fibrillation(OR,5.234;95%CI,1.035-26.471,p=0.045)and procedural time>120min(OR,5.664;95%CI,1.051-30.352,p=0.044)were significantly associated with intracranial hemorrhage.Patients with intracranial hemorrhage transformation after endovascular treatment had significantly different clinical neurological outcomes at 3 months than those without and they had a higher risk of poor outcomes(P=0.01).Conclusion:1.Clot burden score was closely related to the transformation of intracranial hemorrhage after endovascular treatment in patients with acute anterior circulation ischemic stroke.Low clot burden score is an independent risk factor for the transformation of intracranial hemorrhage2.Intracranial hemorrhage transformation after endovascular treatment may increase the risk of patients with poor prognosis,especially in patients with symptomatic hemorrhage.3.Clot burden score can be used as a basis for the risk assessment of patients before treatment,which deserves the attention of clinicians.