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29.07.2023 | Original Communication

Pre-treatment risk markers for hemorrhagic transformation in posterior circulation acute ischemic stroke treated with reperfusion therapy

verfasst von: Claire Ancelet, Sophie Neveü, Laura Venditti, Jonathan Cortese, Oliver Chassin, Coralie Pelissou, Elsa Talab Berthou, Matthias Babin, Ghaidaa Nasser, Farida Benoudiba, Nicolas Legris, Mariana Sarov Rivière, Nicolas Chausson, Laurent Spelle, Christian Denier

Erschienen in: Journal of Neurology | Ausgabe 11/2023

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Abstract

Background

Hemorrhagic transformation (HT) is an uncommon complication of posterior circulation acute ischemic stroke (PCS) compared to anterior circulation stroke. Nevertheless, it remains a major concern especially following reperfusion therapy. This study aimed at identifying potential predictive factors associated with HT in PCS.

Methods

Consecutive patients, from a multicenter cohort, with PCS treated by IVT or EVT or the combination of both, were included from December 2015 to May 2019. The European Cooperative Acute Stroke Study criteria was used to identify HT. Potential risk factors were analyzed using univariate and multivariable testing models.

Results

A total of 96 patients were included in our study. Median age was 66 (57–83) years, 54 patients (56%) were male and median baseline NIHSS was 8 (4–14). 77 patients (80%) received IVT and 54 patients (56%) benefited from EVT. HT occurred in 19 patients (20%), while sHT occurred in 3 patients (3%). HT was found to be associated with poor functional status at 3 months in univariate analysis (p = 0.0084). Multivariable analysis confirmed that higher baseline NIHSS (OR 1.1008; 95% CI [1.0216–1.1862]; p = 0.0117) and lobar topography of ischemia (OR 4.4275; 95% CI [1.3732–14.2753]; p = 0.0127) were independent predictors of the occurrence of HT.

Discussion

HT is associated with increased morbidity in patients with PCS; higher NIHSS and lobar ischemia were independent predictors of HT in our population. Easy-to-use predictive markers may help to tailor therapeutic management of patients with PCS.

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Titel: Pre-treatment risk markers for hemorrhagic transformation in posterior circulation acute ischemic stroke treated with reperfusion therapy
verfasst von: Claire Ancelet
Sophie Neveü
Laura Venditti
Jonathan Cortese
Oliver Chassin
Coralie Pelissou
Elsa Talab Berthou
Matthias Babin
Ghaidaa Nasser
Farida Benoudiba
Nicolas Legris
Mariana Sarov Rivière
Nicolas Chausson
Laurent Spelle
Christian Denier
Publikationsdatum: 29.07.2023
Verlag: Springer Berlin Heidelberg
Erschienen in: Journal of Neurology / Ausgabe 11/2023
Print ISSN: 0340-5354
Elektronische ISSN: 1432-1459
DOI: https://doi.org/10.1007/s00415-023-11886-w

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