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Predictive Factors for Hemorrhagic Transformation after Successful Mechanical Thrombectomy in Cerebral Large Vessel Occlusion

Background: Recently, updated guidelines showthat mechanical thrombectomy has high degree evidence to treat acute ischemic stroke due to cerebral large vessel occlusion (LVO). However, hemorrhagic transformation (HT) occurs in some cases after recanalization, and it is associated with poor prognosis. Prevention of HTafter recanalization therapyis thought to be important. In this study, we aimed to investigate factors related to HT after mechanical thrombectomyfor patients with LVO.

Methods: We included patients with cerebral LVO at anterior circulation within 24 hours from onset and presented successful recanalization by mechanical thrombectomy. We divided them into two groups, with HT, and without HT. We compared their characteristics, such as severity of clinical symptom, etiology, radiological findings between these groups.

Results: This study showed that mild white matter lesion (Fazekas scale <2), high Alberta Stroke Program Early CT (ASPECTS) score (>6) were independent factor of absence of HT after mechanical thrombectomy (odds ratio 3.57, p = 0.004, odds ratio 2.82, p< 0.040, respectively).

Conclusion: Severe white matter lesion and low ASPECS score at the time of admission might be predictors for HT after recanalization in patients with LVO.


Nobuaki Yamamoto,  Yuki Yamamoto,  Kazutaka Kuroda,  Izumi Yamaguchi,  Shu Sogabe,  Takeshi Miyamoto,  Kenji Shimada, Yasuhisa Kanematsu, Ryoma Morigaki,  Yuishin Izumi, and  Yasushi Takagi

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