Clinical and Demographic Factors Associated With Hemorrhagic Transformation Subtypes After Endovascular Thrombectomy for Acute Ischemic Stroke.

backgroundHemorrhagic transformation (HT) after endovascular thrombectomy (EVT) is associated with worse neurological outcomes. We sought to identify clinical and demographic factors associated with HT and HT subtypes after EVT.

methodsPatients with anterior circulation large vessel occlusion who underwent first-pass EVT using different thrombectomy devices were enrolled in a global multicenter prospective registry. Baseline clinical characteristics were compared between individuals with and without HT and across HT subtypes 24 hours after EVT. Multivariable logistic regression models were used to determine risk factors associated with HT and HT subtypes.

resultsThe study cohort comprised 1453 patients. Imaging evidence of HT occurred in 40% of patients, of whom 3.2% had symptomatic HT. In a multivariable regression analysis, diabetes (odds ratio [OR], 1.47 [95% CI, 1.09-1.99];

conclusionsGiven that certain risk factors are associated with specific subtypes of HT, our analysis demonstrates the importance of not only reporting symptomatic HT but also classifying HT into subtypes in clinical trials. Identifying risk factors associated with HT subtypes may improve prognostic accuracy and guide post-EVT monitoring. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT03845491.