Study on the influencing factors of contrast extravasation after mechanical thrombectomy in acute great vascular occlusive stroke

doi:10.3877/cma.j.issn.2095-123X.2020.02.009

Abstract

Abstract:

Objective

Patients suffering acute large vascular occlusion (ALVOS) combined with contrast extravasation after mechanical thrombectomy were collected to investigate the clinical characteristics, influencing factors and prognosis.

Methods

Fifty-two patients which were confirmed ALVOS by Stroke Center of Affiliated Hospital of Chengdu University from January 2018 to February 2020 and successfully recanalized by mechanical thrombectomy were divided into two groups: non-contrast extravasation group (n=22) and contrast extravasation group (n=22). Baseline information, perioperative parameters and prognosis in 90 d after operation were analysed.

Results

There were significant differences between the two groups in terms of the alberta stroke program early CT score, onset to revascularization time, puncture to revascularization and modified Rankin scale scores at 90 d after surgery (P<0.05). Multi-factor analysis showed that bleeding transformation was an independent risk factor for contrast agent extravasation (OR=7.016, 95%CI: 0.021-0.957, P=0.045).

Conclusion

Bleeding transformation is an independent risk factor for contrast agent extravasation after mechanical thrombectomy. ALVOS patients admitted to the hospital showed low-density lesions on CT, long visit time after onset, and long recanalization time of blood vessels in the hospital, which can lead to extravasation of contrast agent after mechanical thrombectomy, suggesting a poor prognosis after stroke.

Key words: Ischemic stroke, Endovascular therapy, Contrast agent extravasation, Mechanical thrombectomy

Chuan Du, Wen Cheng, Quanlong Yang, Yu Zhang, Anxi Zheng, Xiaoming Huang. Study on the influencing factors of contrast extravasation after mechanical thrombectomy in acute great vascular occlusive stroke[J]. Chinese Journal of Brain Diseases and Rehabilitation(Electronic Edition), 2020, 10(02): 106-109.

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References 18

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项目		无外渗组（22例）	外渗组（30例）	χ²/t值	P值
年龄（岁，Mean±SD）		65.82±12.42	60.57±19.10	1.210	0.234
性别[例（%）]				0.258	0.776
	男性	14（63.6）	17（56.7）
	女性	8（36.4）	13（43.3）
房颤[例（%）]		15（68.2）	18（60.0）	0.369	0.576
高血压[例（%）]		8（36.4）	10（31.3）	0.152	0.773
糖尿病[例（%）]		7（31.8）	4（13.3）	2.600	0.169
高脂血症[例（%）]		8（36.4）	8（26.7）	0.561	0.548
肥胖[例（%）]		6（27.3）	4（13.3）	1.592	0.290
吸烟[例（%）]		5（22.7）	8（26.7）	0.114	1.000

项目		无外渗组（22例）	外渗组（30例）	χ²/t值	P值
年龄（岁，Mean±SD）		65.82±12.42	60.57±19.10	1.210	0.234
性别[例（%）]				0.258	0.776
	男性	14（63.6）	17（56.7）
	女性	8（36.4）	13（43.3）
房颤[例（%）]		15（68.2）	18（60.0）	0.369	0.576
高血压[例（%）]		8（36.4）	10（31.3）	0.152	0.773
糖尿病[例（%）]		7（31.8）	4（13.3）	2.600	0.169
高脂血症[例（%）]		8（36.4）	8（26.7）	0.561	0.548
肥胖[例（%）]		6（27.3）	4（13.3）	1.592	0.290
吸烟[例（%）]		5（22.7）	8（26.7）	0.114	1.000

项目		无外渗组（n=22）	外渗组（n=30）	χ²/t值	P值
梗死位置[例（%）]				0.771	0.488
	前循环	19（86.4）	23（76.7）
	后循环	3（13.6）	7（23.3）
IVT[例（%）]		12（54.5）	20（62.5）	0.342	0.559
入院NIHSS评分（分，Mean±SD）		16.45±7.00	20.27±8.50	-1.719	0.091
ASPECTS评分（分，Mean±SD）		8.95±0.95	8.17±1.10	2.783	0.008
ORT（min，Mean±SD）		275.82±56.02	323.27±81.68	-2.476	0.016
PRT（min，Mean±SD）		104.45±39.58	128.93±29.71	-2.400	0.020
取栓次数（次，Mean±SD）		2.23±1.15	2.47±0.73	-0.863	0.398
出血转化[例（%）]		2（9.1）	9（30.0）	3.331	0.092
术后90 d mRs评分（分，Mean±SD）		2.32±1.64	3.80±1.61	-3.251	0.002

项目		无外渗组（n=22）	外渗组（n=30）	χ²/t值	P值
梗死位置[例（%）]				0.771	0.488
	前循环	19（86.4）	23（76.7）
	后循环	3（13.6）	7（23.3）
IVT[例（%）]		12（54.5）	20（62.5）	0.342	0.559
入院NIHSS评分（分，Mean±SD）		16.45±7.00	20.27±8.50	-1.719	0.091
ASPECTS评分（分，Mean±SD）		8.95±0.95	8.17±1.10	2.783	0.008
ORT（min，Mean±SD）		275.82±56.02	323.27±81.68	-2.476	0.016
PRT（min，Mean±SD）		104.45±39.58	128.93±29.71	-2.400	0.020
取栓次数（次，Mean±SD）		2.23±1.15	2.47±0.73	-0.863	0.398
出血转化[例（%）]		2（9.1）	9（30.0）	3.331	0.092
术后90 d mRs评分（分，Mean±SD）		2.32±1.64	3.80±1.61	-3.251	0.002

项目	偏回归系数	标准误	Wald值	OR	95%CI	P值
入院NIHSS评分	-0.046	0.060	0.590	0.955	0.849~1.074	0.442
ASPECTS评分	-0.873	0.459	3.608	0.418	0.170~1.028	0.058
ORT	0.000	0.007	0.000	1.000	0.986~1.014	0.989
PRT	0.019	0.013	2.169	1.019	0.994~1.045	0.141
出血转化	1.955	0.975	4.019	7.061	0.021~0.957	0.045

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