Hemorrhagic Complications of Mechanical Thrombectomy for Acute Ischemic Stroke:
A Single-Center Study of Related Factors
Yoshinori Takaya1, Fumitaka Yamane1*, Shinya Kohyama2, Keisuke Onoda1 and Akira Matsuno1
1Graduate School of Medicine, International University of Health and Welfare (IUHW), Narita, Chiba, Japan
2Department of Endovascular Neurosurgery, International Medical Center, Saitama Medical University, Hidaka, Saitama, Japan
*Corresponding Author: Fumitaka Yamane, Graduate School of Medicine,
International University of Health and Welfare (IUHW), Narita, Chiba, Japan.
Received:
October 16, 2023; Published: December 13, 2023
Abstract
Background: Mechanical thrombectomy (MT) is an effective treatment for acute ischemic stroke with large vessel occlusions (LVO). However, MT also carries a risk of hemorrhagic complications (HC). In this study, we analyzed factors associated with HC at a single center, with particular attention to intraoperative factors.
Methods: We identified 312 patients (193 males, 119 females) that underwent MT at our center. The average age was 75.2 years. Clinical and technical complications were retrospectively identified and related factors were extracted from surgical records and examined in relation to bleeding complications.
Results: Of all identified cases, 38 cases (14.5%) experienced HC. The HC group was older than the non-HC group (77.9 years vs. 74.8 year), although this difference was not statistically significant (p = 0.158). No significant associations were found between site of occlusion, infarct breakdown, National Institutes of Health Stroke Scale (NIHSS) score, Alberta Stroke Program Early computed tomography (CT) Score (ASPECTS), MT method, or time to recanalization factors. The modified Thrombolysis In Cerebral Infarction (mTICI) score showed a significantly large proportion of TICI 2B in the HC group and TICI 3 in the non-HC group.
Conclusions: The only factor associated with HC was the degree of recanalization, specifically mTICI 2B or less. Patients with a longer recanalization time-especially cases where the procedure was terminated at mTICI 2B-may require more rigorous postoperative management.
Keywords: Mechanical Thrombectomy; Hemorrhagic Complications; Modified Thrombolysis in Cerebral Infarction; Intraprocedural Bleeding; Post Thrombectomy Control
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