Affiliation:
1. Department of Neurology, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.
Abstract
Background:
Contrast extravasation (CE) on brain non-contrast computed tomography
(NCCT) after endovascular therapy (EVT) is commonly present in patients with acute ischemic stroke
(AIS). Substantial uncertainties remain about the relationship between the spatial location of CE and
symptomatic intracranial hemorrhage (sICH). Therefore, this study aimed to evaluate this association.
Methods:
We performed a retrospective screening on consecutive patients with AIS due to LVO
(AIS-LVO) who had CE on NCCT immediately after EVT for anterior circulation large vessel occlusion
(LVO). We used the Alberta stroke program early CT Score (ASPECTS) scoring system to
estimate the spatial location of CE. Multivariable logistic regression was performed to achieve the
risk factors of sICH.
Results:
In this study, 115 of 153 (75.1%) anterior circulation AIS-LVO patients had CE on
NCCT. After excluding 9 patients, 106 patients were enrolled in the final analysis. In multivariate
regression analysis, atrial fibrillation (AF) (adjusted OR [aOR] 6.833, 95% confidence interval
[CI] 1.331-35.081, P = 0.021) and CE-ASPECTS (aOR 0.602, 95% CI 0.411-0.882 P = 0.009)
were associated with sICH. In subgroup analysis, CE at the internal capsule (IC) region was an
independent risk factor for sICH (aOR 5.992, 95% CI 1.010-35.543 P < 0.05). These and conventional
variables were incorporated as a predict model, with AUC of 0.899, demonstrating good
discrimination and calibration for sICH in this study cohort.
Conclusion:
The spatial location of CE on NCCT immediately after EVT was an independent and
strong risk factor for sICH in acute ischemic stroke patients.
Publisher
Bentham Science Publishers Ltd.
Subject
Cellular and Molecular Neuroscience,Developmental Neuroscience,Neurology,Neurology (clinical)