Early Venous Filling Following Thrombectomy: Association With Hemorrhagic Transformation and Functional Outcome

Frontiers in Neurology

Thomas Bonnet¹  Benjamin Mine¹  Boris Lubicz¹  Sophie Elands²  Gilles Naeije²  Pierre Casimir²  Noémie Ligot²  Martin Sjøgård³ 

[1] Department of Interventional Neuroradiology, Erasmus Hospital, Université Libre de Bruxelles, Brussels, Belgium;Department of Neurology, Erasmus Hospital, Université Libre de Bruxelles, Brussels, Belgium;Laboratoire de Cartographie Fonctionnelle du Cerveau, Neuroscience Institute (ULB-Neuroscience Institute), Université Libre de Bruxelles, Brussels, Belgium;

关键词: acute stroke;    angiography digital subtraction;    early venous filling;    cerebral hemorrhage;    thrombectomy;    reperfusion after ischemia;   

DOI  :  10.3389/fneur.2021.649079

来源: DOAJ

【 摘 要 】

Background and Purpose: Previous studies have noted the angiographic appearance of early venous filling (EVF) following recanalisation in acute ischemic stroke. However, the prognostic implications of EVF as a novel imaging biomarker remain unclear. We aimed to evaluate the correlation between EVF with (i) the risk of subsequent reperfusion hemorrhage (RPH) and (ii) the association of EVF on both the NIHSS score at 24 h and functional outcome as assessed with the Modified Rankin Scale (mRS) score at 90 days.Methods: We conducted a retrospective cohort study of patients presenting with an acute ischemic stroke due to a proximal large-vessel occlusion of the anterior circulation treated by thrombectomy. Post-reperfusion digital subtraction angiography was reviewed to look for EVF as evidenced by the contrast opacification of any cerebral vein before the late arterial phase.Results: EVF occurred in 22.4% of the 147 cases included. The presence of EVF significantly increased the risk of RPH (p = 0.0048), including the risk of symptomatic hemorrhage (p = 0.0052). The presence of EVF (p = 0.0016) and the absence of RPH (p = 0.0021) were independently associated with a better outcome as defined by the NIHSS difference at 24 h, most significantly in the EVF+RPH− group. No significant relationship was however found between either EVF or RPH and a mRS score ≤ 2 at 90 days.Conclusion: Early venous filling on angiographic imaging is a potential predictor of reperfusion hemorrhage. The absence of subsequent RPH in this sub-group is associated with better outcomes at 24 h post-thrombectomy than in those with RPH.

【 授权许可】

Unknown