Department of Neurology, Hangzhou First Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Department of Neurology, Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China.
J Int Med Res. 2021 Oct;49(10):3000605211049074. doi: 10.1177/03000605211049074.
The risk factors associated with iodine contrast extravasation immediately after endovascular thrombectomy (EVT) and subsequent hemorrhagic transformation within 24 hours remain unclear.
Mixed images, iodine overlay maps, and virtual non-contrast images were reconstructed from 106 consecutive acute ischemic stroke patients who underwent dual energy computed tomography immediately and 24 hours after EVT. Multivariate analyses of clinical and radiological data were performed to explore independent predictors of iodine contrast extravasation and hemorrhagic transformation.
Sixty-eight (64.2%) patients exhibited pure iodine contrast extravasation after EVT; 30.9% developed hemorrhagic transformation within 24 hours after EVT. The number of stent retriever passes was independently associated with both iodine contrast extravasation (odds ratio 1.608; 95% confidence interval (CI) 1.047-2.469) and subsequent hemorrhagic transformation (odds ratio 1.477; 95% CI 1.003-2.175). Patients with more than two stent retriever passes were more likely to exhibit iodine contrast extravasation (sensitivity = 68.2%, specificity = 81.5%), while those with more than three stent retriever passes more often exhibited hemorrhage after iodine contrast extravasation (sensitivity = 64.6%, specificity = 87.2%).
The number of stent retriever passes was an independent predictor for both iodine contrast extravasation and subsequent hemorrhagic transformation.
血管内血栓切除术（EVT）后即刻碘造影剂外渗与 24 小时内出血性转化的相关危险因素尚不清楚。
对 106 例连续急性缺血性脑卒中患者，在 EVT 后即刻和 24 小时行双能 CT 混合图像、碘覆盖图和虚拟非对比图像重建，对临床和影像学资料进行多变量分析，探讨碘造影剂外渗和出血性转化的独立预测因素。
68 例（64.2%）患者 EVT 后表现为单纯碘造影剂外渗；30.9%的患者在 EVT 后 24 小时内发生出血性转化。支架取栓器通过次数与碘造影剂外渗（比值比 1.608；95%置信区间 1.047-2.469）和随后的出血性转化（比值比 1.477；95%置信区间 1.003-2.175）独立相关。支架取栓器通过次数超过 2 次与碘造影剂外渗（敏感性=68.2%，特异性=81.5%）相关，而支架取栓器通过次数超过 3 次更易发生碘造影剂外渗后的出血（敏感性=64.6%，特异性=87.2%）。
支架取栓器通过次数是碘造影剂外渗和随后出血性转化的独立预测因素。
