Effect of thrombus pathology on hemorrhagic transformation after mechanical thrombectomy in patients with acute intracranial large vessel occlusive cerebral infarction
Objective:To investigate the effect of thrombus pathology on hemorrhagic transformation after mechanical thrombectomy in patients with acute intracranial large vessel occlusive(LVO)cerebral infarction.Methods:Clinical data were collected from 145 patients with acute intracranial LVO cerebral infarction treated in People's Hospital of Taihe County between June 2020 and May 2022.Based on the occurrence of hemorrhagic transformation after mechanical thrombectomy,the patients were divided into hemorrhagic transformation group and non-hemorrhagic transformation group.Baseline data and thrombus pathology were compared between the two groups,and thrombus pathological factors influencing hemorrhagic transformation were analyzed.Results:Thirty out of the 145 patients(20.69%)developed hemorrhagic transformation after mechanical thrombectomy.Patients in the hemorrhagic transformation group had higher National Institutes of Health Stroke Scale(NIHSS)scores at admission,greater frequency of multiple thrombectomies,and a larger proportion of red blood cell enrichment in thrombi compared to those in the non-hemorrhagic transformation group(P<0.05).All these factors were positively correlated with hemorrhagic transformation after mechanical thrombectomy(P<0.05).Multivariate logistic regression analysis showed that higher NIHSS scores at admission,multiple thrombectomies,and red blood cell enrichment in thrombi were all risk factors for hemorrhagic transformation after mechanical thrombectomy in patients with acute intracranial LVO cerebral infarction(P<0.05).Conclusion:Red blood cell enrichment in thrombi may increase the risks of hemorrhagic transformation in patients with acute intracranial LVO cerebral infarction following mechanical thrombectomy.