Subarachnoid contrast accumulation and Alberta Stroke Program Early CT Score applied to contrast accumulation after thrombectomy as predictors of symptomatic hemorrhage.

Subarachnoid contrast accumulation and Alberta Stroke Program Early CT Score applied to contrast accumulation after thrombectomy as predictors of symptomatic hemorrhage.:

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Subarachnoid contrast accumulation and Alberta Stroke Program Early CT Score applied to contrast accumulation after thrombectomy as predictors of symptomatic hemorrhage.

World Neurosurg. 2020 Mar 26;:

Authors: Kim H, Lee SJ, Lee TK, Jung KO

Abstract

BACKGROUND: Areas of contrast accumulation (CA) are commonly found on routine computed tomography (CT) performed immediately after thrombectomy. In this study, we attempted to investigate the types of CA associated with outcomes, including symptomatic intracranial hemorrhage (sICH).

METHODS: This study analyzed a total of 145 patients with anterior circulation stroke who underwent non-contrast conventional CT immediately after thrombectomy. The following variables were investigated: collateral status, failure of recanalization, Alberta Stroke Program Early CT Score (ASPECTS) applied to CA lesions and diffusion-weighted imaging infarct lesions, and sICH.

RESULTS: Among the 145 patients, 102 (70.3%) had CA lesions. All types of CA (any CA, cortical CA, subarachnoid CA, and CA ASPECTS) were significantly associated with poor outcome (modified Rankin scale score > 2). In particular, subarachnoid CA (odds ratio, 23.994; 95% confidence interval, 4.696-122.589) and CA ASPECTS (odds ratio, 0.550; 95% confidence interval, 0.404-0.750) were independently associated with sICH. Patients with subrachnoid CA had a poorer collateral status and a larger final infarct size than those without subarachnoid CA although initial National Institutes of Health Stroke Scale score and recanalization rate were comparable between the groups. CA ASPECTS ≤ 5 predicted sICH with a sensitivity of 66.7% and a specificity of 92.6% (area under the curve, 0.854).

CONCLUSIONS: Our data suggest that a subarachnoid CA location and CA ASPECTS are predictors of sICH. In particular, a subarachnoid location of CA might signify damage of subarachnoid collateral arteries leading to a larger infarct.

PMID: 32224268 [PubMed - as supplied by publisher]