Influencing factors of PH2 intracranial hemorrhage after endovascular treatment in acute ischemic stroke: analysis of 64 cases

Abstract

Objective To investigate the influencing factors of intracranial hemorrhage (ICH) of parenchymal hemorrhage type 2 (PH2) after endovascular treatment (EVT) in patients with acute ischemic stroke (AIS). Methods A total of 64 AIS patients who were admitted to the First Affiliated Hospital of Army Medical University and received endovascular treatment from April 1, 2020 to December 31, 2020 were enrolled in this study, and the presence of PH2 ICH was determined by cranial CT scanning within 72 h after operation. The clinical data of the patients were collected and retrospectively reviewed, including age, gender, hypertension, diabetes, hyperlipidemia, coronary heart disease, atrial fibrillation, stroke history, National Institutes of Health Stroke Scale (NIHSS) score, blood pressure, blood glucose, glycosylated hemoglobin, platelet, international normalized ratio (INR), cardiogenic embolism, preoperative antithrombotic therapy, preoperative intravenous thrombolysis, and Alberta Stroke Program Early CT Score (ASPECTS). Results Among all the 64 patients, 28 cases (28/64, 43.8%) were diagnosed with ICH within 72 h after surgery, among which 9 cases (9/64, 14.1%) had PH2 ICH. In the PH2 group, the median blood glucose (7.50 vs 6.58, P=0.039), proportion of women (77.8% vs 38.2%, P=0.035), and proportion of cardiogenic embolism (88.9% vs 49.1%, P=0.033) were significantly higher, whereas the median ASPECTS (6 vs7, P=0.026) and proportion of ASPECTS >6 (22.2% vs 63.6%, P=0.029) were greatly lower than those of the non-PH2 group. In addition, the increased blood glucose presented as a risk factor for the occurrence of PH2 ICH (OR=1.48, 95%CI: 1.00~2.18). Conclusion Elevated blood glucose may increase the risk of developing PH2 ICH after EVT in patients with AIS.

Keywords

• acute ischemic stroke
• endovascular therapy
• intracranial hemorrhage
• risk factors