Predictors of intracranial hemorrhage in patients with large vessel occlusion stroke who underwent successful recanalization of the anterior system

Abstract

Aim: To determine the causes of intracranial hemorrhage (ICH) following endovascular thrombectomy (EVT) in patients with large vessel system (LVO). ICH is a cause of fatal birth defects and morbidity. This study was designed to evaluate the causes of ICH after successful mechanical thrombectomy (MT) in patients with acute ischemic stroke.

Methods: This retrospective study included isolation of anterior circulation LVO with ASPECTS scores > 6, where symptoms were successfully treated with recanalization from 6 hours onwards. The study aimed to investigate the causes of intracranial hemorrhage occurring within 24 hours.

Results: The study included 123 patients with a history of LVO ischemic stroke. ICH developed in 37 (30%) patients. Low ASPECT score (p<0.01), high 24-hour NIHS score (p<0.01), high passage rates (p<0.01), low lymphocyte count (p<0.01), high 3-month MRS score (p<0.01), presence of hyperlipidemia (p<0.05), low first-pass recanalization rate (p<0.01), presence of distal embolism (p<0.01), and growth rate of cardioembolic stroke etiology (p<0.01) were associated with the progression of ICH development. In a multivariate logistic regression model, cardioembolic etiology was found to be an independent predictor of ICH.

Conclusion: A low ASPECT score, high 24-hour NIHS score, high pass counts, low lymphocyte counts, high 3-month MRS score, presence of hyperlipidemia, low first-pass recanalization rate, and presence of distal embolism indicated the progression of ICH. The etiology of cardioembolic stroke was an independent vision of ICH.