机械取栓术后症状性颅内出血——等渗与低渗造影剂之间的差异
Symptomatic Intracranial Hemorrhage after Mechanical Thrombectomy - the Difference between Iso-Osmolar and Low-Osmolar Contrast Media.
作者信息
Wada Takeshi, Takayama Katsutoshi, Myouchin Kaoru, Kishida Hayato, Chanoki Yuto, Oshima Keisuke, Masutani Takahiro, Uchiyama Yoshitomo, Tanaka Toshihiro
机构信息
Department of Interventional Neuroradiology/Radiology, Kouseikai Takai Hospital, Tenri, Nara, Japan.
Department of Radiology, Nara Medical University, Kashihara, Nara, Japan.
出版信息
J Neuroendovasc Ther. 2023;18(1):18-23. doi: 10.5797/jnet.oa.2023-0074. Epub 2023 Dec 8.
OBJECTIVE
Symptomatic intracranial hemorrhage (SICH) after mechanical thrombectomy (MT) is generally considered a critical complication. Hemorrhagic transformation after ischemic stroke has also been associated with contrast media administration. The objective of our study was to evaluate correlations between contrast media type and incidence of SICH after MT.
METHODS
Ninety-three consecutive patients (41 men; mean age, 80.2 years; range, 44-98 years) underwent MT reperfusion (expanded thrombolysis in cerebral infarction score, 2a-3) for acute large-vessel occlusion ischemic stroke within 8 h after symptom onset between April 2020 and July 2023 were retrospectively reviewed. Correlations between contrast media type (iso-osmolar or low-osmolar medium) and incidence of SICH were assessed.
RESULTS
Contrast media were iso-osmolar in 60 cases or low-osmolar in 33 cases. The overall incidence of SICH was 5.5%. The frequency of SICH was significantly lower in the iso-osmolar group (1.7%) than in the low-osmolar group (12.1%; P = 0.033).
CONCLUSION
Iso-osmolar contrast media was associated with a lower incidence of SICH compared with low-osmolar contrast media in patients after MT.
目的
机械取栓（MT）后症状性颅内出血（SICH）通常被认为是一种严重并发症。缺血性卒中后的出血性转化也与造影剂的使用有关。我们研究的目的是评估造影剂类型与MT后SICH发生率之间的相关性。
方法
回顾性分析2020年4月至2023年7月期间93例连续患者（41例男性；平均年龄80.2岁；范围44-98岁），这些患者在症状发作后8小时内接受MT再灌注（脑梗死扩展溶栓评分，2a-3）治疗急性大血管闭塞性缺血性卒中。评估造影剂类型（等渗或低渗介质）与SICH发生率之间的相关性。
结果
60例使用等渗造影剂，33例使用低渗造影剂。SICH的总体发生率为5.5%。等渗组SICH的发生率（1.7%）显著低于低渗组（12.1%；P=0.033）。
结论
与低渗造影剂相比，MT后患者使用等渗造影剂与较低的SICH发生率相关。
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