Analysis of risk factors for hemorrhage transformation and establishment of risk prediction model after mechanical thrombectomy in acute large vessel occlusion

Objective To explore the risk factors and the establishment of a risk prediction model for the hemorrhagic transformation after mechanical thrombectomy in acute large vessel occlusion. Methods A total of 110 patients with successful recanalization of responsible blood vessels after stent embolization from acute large vessel occlusion in Second Affiliated Hospital of Bengbu Medical College from February 2017 to November 2019 were selected and divided into a bleeding group and a non-bleeding group. Among them, 30 cases of the bleeding group and 80 cases of the non-bleeding group, the general clinical data, imaging data and operation related data of the two groups were counted. The collected data were analyzed by single factor analysis and multiple factor logistic regression analysis. Results The results of single factor analysis showed that the drinking habits, antiplatelet, occluded vessels, whether the contrast agent oozes out, time from onset to recanalization(OTR), time from puncture to recanalization(PTR), early CT score of Alberta stroke project(ASPECT), the National Institutes of Health Stroke Scale(NIHSS) score 24 h after surgery had statistical difference between the two groups(P<0.05). Multi-factor analysis results showed that middle cerebral artery occlusion(OR=24.130, P=0.030), PTR(OR=0.555, P=0.008) were risk factors, and the ASPECT score(OR=0.345, P=0.001) was the protective factor, and whether intracranial hemorrhage after mechanical thrombectomy for acute cerebral infarction mainly depended on the ASPECT score, followed by whether the brain occurs middle arterial occlusion, and finally PTR size. Conclusion Middle cerebral artery occlusion, ASPECT score and PTR are independent influencing factors of intracranial hemorrhage after mechanical thrombectomy for acute cerebral infarction.