Zhongyun Chen1, Yingbo Zhang2, Yingying Su3, Yijia Sun1, Yanbo He4, Hongbo Chen5. 1. Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China. 2. Department of Neurology, Beijing Tsinghua Changgung Hospital affiliated to Tsinghua University, Beijing, China. 3. Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China. Electronic address: suyingyingxwyy@163.com. 4. Department of Neurology, The Beijing Moslem People Hospital, Beijing, China. 5. Department of Neurology, Liangxiang Hospital of Beijing Fangshan District, , Beijing, China.
Abstract
OBJECTIVE: To investigate whether contrast extravasation on dual-energy computed tomography (DECT) in patients with acute ischemic stroke (AIS) after endovascular therapy (EVT) are related to hemorrhagic transformation (HT) and poor short-term clinical outcomes. METHODS: A retrospective analysis was conducted on AIS patients who underwent EVT at Xuanwu hospital between November 2016 and January 2019. DECT was performed on all patients within 24 hours after EVT. Baseline demographic and clinical data were analyzed between patients with and without contrast extravasation and between patients with HT and non-HT, good and poor outcomes at 3 months post-EVT. RESULTS: A total of 166 patients were included in the study with 51 (30.7%) patients experiencing contrast extravasation. Compared to patients without contrast extravasation, patients with contrast extravasation had longer onset to reperfusion time (444.8 minutes versus 374.0 minutes, P = .044) and higher percentages of greater than 3 retriever passes (16.7% versus 31.4%, P = .030). Contrast extravasation was associated with higher risk of HT (P = .038), poor outcome after discharge (P = .030), and longer hospital stay (P = .034). Multivariate analysis showed that contrast extravasation occurrence was an independent factor for HT (OR = 2.150, 95% CI 1.060-4.360, P = .034) and poor short-term outcome (OR = 2.936; 95% CI 1.147-7.518, P = .025). CONCLUSIONS: The presence of contrast extravasation within 24 hours of EVT may be associated with higher risks of HT and may be predictive of unfavorable functional outcomes in AIS patients.
OBJECTIVE: To investigate whether contrast extravasation on dual-energy computed tomography (DECT) in patients with acute ischemic stroke (AIS) after endovascular therapy (EVT) are related to hemorrhagic transformation (HT) and poor short-term clinical outcomes. METHODS: A retrospective analysis was conducted on AIS patients who underwent EVT at Xuanwu hospital between November 2016 and January 2019. DECT was performed on all patients within 24 hours after EVT. Baseline demographic and clinical data were analyzed between patients with and without contrast extravasation and between patients with HT and non-HT, good and poor outcomes at 3 months post-EVT. RESULTS: A total of 166 patients were included in the study with 51 (30.7%) patients experiencing contrast extravasation. Compared to patients without contrast extravasation, patients with contrast extravasation had longer onset to reperfusion time (444.8 minutes versus 374.0 minutes, P = .044) and higher percentages of greater than 3 retriever passes (16.7% versus 31.4%, P = .030). Contrast extravasation was associated with higher risk of HT (P = .038), poor outcome after discharge (P = .030), and longer hospital stay (P = .034). Multivariate analysis showed that contrast extravasation occurrence was an independent factor for HT (OR = 2.150, 95% CI 1.060-4.360, P = .034) and poor short-term outcome (OR = 2.936; 95% CI 1.147-7.518, P = .025). CONCLUSIONS: The presence of contrast extravasation within 24 hours of EVT may be associated with higher risks of HT and may be predictive of unfavorable functional outcomes in AIS patients.
Authors: Sara Bernardo-Castro; João André Sousa; Ana Brás; Carla Cecília; Bruno Rodrigues; Luciano Almendra; Cristina Machado; Gustavo Santo; Fernando Silva; Lino Ferreira; Isabel Santana; João Sargento-Freitas Journal: Front Neurol Date: 2020-12-09 Impact factor: 4.003
Authors: Ronda Lun; Gregory B Walker; Adrien Guenego; Mohammed Kassab; Eduardo Portela; Vignan Yogendrakumar; George Medvedev; Ken Wong; Michel Shamy; Dar Dowlatshahi; Robert Fahed Journal: Front Neurol Date: 2020-12-22 Impact factor: 4.003