Prediction of parenchymal hematoma after mechanical thrombectomy by asymmetrical prominent veins: a retrospective cohort study based on susceptibility-weighted imaging.

BACKGROUND

Asymmetrical prominent veins (APVs) can help predict perfusion deficits and collateral circulation in large vessel occlusion acute ischemic stroke. Therefore, this study aimed to investigate the predictive value of APVs for parenchymal hematoma (PH) following mechanical thrombectomy (MT).

METHODS

This study retrospectively included consecutive patients with ischemic stroke due to middle cerebral artery occlusion who underwent MT. APVs were quantified using the APVs-Alberta Stroke Program Early Computed Tomography Score (ASPECTS) system, and we recorded the length and diameter of the susceptibility vessel sign (SVS), the number of cerebral microbleeds (CMBs), post-MT blood flow grading, and whether PH occurred within 24 hours. Logistic regression was performed to identify risk factors for PH.

RESULTS

A total of 89 patients with acute middle cerebral artery occlusion were included. APVs-ASPECTS was identified as an independent predictor of PH [odds ratio (OR) =0.604 (0.392, 0.930); P=0.022], and the length of SVS [OR =0.882 (0.792, 0.981); P=0.021] was an independent predictor of successful recanalization [modified Thrombolysis In Cerebral Ischemia (mTICI) 2b/3] after MT. There was no significant difference in the number of CMBs between the PH (+) and PH (-) groups (P=0.341).

CONCLUSIONS

In patients with acute middle cerebral artery occlusion who underwent MT, APVs-ASPECTS may be associated with the risk of PH.