Hassan Ameer E, Kotta Hari, Shariff Umar, Preston Laurie, Tekle Wondwossen, Qureshi Adnan
Department of Neurology and Radiology, University of Texas Rio Grande Valley, Harlingen, TX, United States.
Department of Neurology, University of Texas Medical Branch, Galveston, TX, United States.
Front Neurol. 2019 Aug 8;10:818. doi: 10.3389/fneur.2019.00818. eCollection 2019.
Previous research has focused on the association between hemorrhagic transformation (HT) incidence and pre-procedural variables (i.e., baseline variables) rather than the association between HT incidence and endovascular treatment (EVT) procedural variables (e.g., stent retriever passes). To assess the association, if any, that exists between the number of stent retriever passes per procedure and the incidence of HT for patients undergoing mechanical thrombectomy. An endovascular database from a comprehensive stroke center was used to collect data on EVT patients treated with Trevo, Solitaire, or Penumbra stent retrievers from the years 2012 to 2017. Statistical analyses were conducted on the stent retriever passes, demographics, morbidities, medication usage, and outcomes and their association with HT. Of the 329 total patients, 46 (14%) had HT. The HT group had an average [SD] of 1.65 [0.67] and range of [1-3] passes per procedure while the non-HT group had an average [SD] of 1.63 [0.86] and range of [1-5] passes per procedure. Admission NIHSS score ( = 0.0003) and the incidence of diabetes mellitus (DM) ( = 0.05) were significantly higher in the HT group. Subdividing HT into symptomatic and asymptomatic ICH groups failed to display significant differences in the distribution of the stent retriever passes ( = 0.969). The number of passes failed to show any association with HT ( = 0.804) while admission NIHSS score was found to have an OR of 1.07 (95%CI: 1.029-1.121, = 0.001) with HT incidence. No significant association was found between HT incidence and the stent retriever passes. Further multicenter studies are warranted to corroborate our results.
以往的研究主要关注出血性转化（HT）发生率与术前变量（即基线变量）之间的关联，而非HT发生率与血管内治疗（EVT）手术变量（如支架取栓器通过次数）之间的关联。为了评估接受机械取栓术的患者每次手术的支架取栓器通过次数与HT发生率之间是否存在关联。使用一家综合卒中中心的血管内数据库收集2012年至2017年接受Trevo、Solitaire或Penumbra支架取栓器治疗的EVT患者的数据。对支架取栓器通过次数、人口统计学、发病率、药物使用情况和结局及其与HT的关联进行了统计分析。在总共329例患者中，46例（14%）发生了HT。HT组每次手术的平均[标准差]为1.65[0.67]，范围为[1 - 3]次通过，而非HT组每次手术的平均[标准差]为1.63[0.86]，范围为[1 - 5]次通过。HT组的入院美国国立卫生研究院卒中量表（NIHSS）评分（P = 0.0003）和糖尿病（DM）发生率（P = 0.05）显著更高。将HT细分为有症状和无症状颅内出血组，在支架取栓器通过次数的分布上未显示出显著差异（P = 0.969）。通过次数与HT未显示出任何关联（P = 0.804），而入院NIHSS评分与HT发生率的比值比为1.07（95%置信区间：1.029 - 1.121，P = 0.001）。未发现HT发生率与支架取栓器通过次数之间存在显著关联。有必要进行进一步的多中心研究来证实我们的结果。
