CLINICAL ANALYSIS OF RELATED FACTORS OF INTRACRANIAL HEMORRHAGE TRANSFORMATION AFTER MECHANICAL THROMBECTOMY IN ACUTE ISCHEMIC STROKE IN ATHLETIC PATIENTS

Abstract

Objective: Current study aims to analyze the related factors of intracranial hemorrhagic transformation (HT) in mechanical thrombectomy for acute ischemic stroke (AIS), so as to help reduce the incidence of of HT in clinical thrombectomy and ultimately benefit athletic patients. Methods: Current study collected the case data of 171 athletic patients with AIS who were treated by mechanical thrombectomy in Neurology of Baotou Central Hospital from January 2013 to January 2018. Collected the population characteristics, surgical and disease related indicators of all mechanical thrombectomy athletic patients. To analyze the clinical factors related to the conversion of HT after embolectomy, and to explore whether HAT score can also be used to evaluate the bleeding after mechanical embolectomy. Statistical comparison of the incidence of complications of HT caused by mechanical thrombectomy every year, and to determine whether there is a learning curve. Results: According to statistics, 49 of 171 athletic patients with mechanical thrombectomy experienced HT. The results of statistical analysis showed that there was no significant difference in the incidence of complications of intracranial HT between different sexes and different age groups (P>0.05); There was a significant correlation between atrial fibrillation and complications of HT in basic diseases (P＜0.05); There are certain differences in the incidence of complications related to thrombectomy bleeding conversion between different treatment time windows (P<0.05); There were statistical differences in the incidence of conversion complications of embolectomy for intracranial HT among athletic patients with different GCS scores, NIHSS scores, HAT scores, and collateral circulation compensation levels (all P<0.05); There was no significant difference in the incidence of HT between different occluded blood vessel thrombectomy methods (P>0.05); The incidence of bleeding conversion in the simple mechanical thrombectomy group was 49% (24/49) compared to the composite thrombectomy group, and 51% (25/49) in the composite thrombectomy group. There was no statistically significant difference between the two groups (P>0.05); There was no statistical significance in the incidence of HT after mechanical thrombectomy in different years (P>0.05), and no learning curve was found. Conclusion: The distribution of blood vessels responsible for thrombectomy is different, and there is no significant difference in the occurrence of transformation of intracranial HT between simple mechanical embolectomy and combined embolectomy. The history of atrial fibrillation, poor collateral circulation compensation, prolonged time from onset to intervention, higher NIHSS score, higher HAT score, and lower GCS score are risk factors for conversion of intracranial HA after embolectomy.