Journal of Neuroendovascular Therapy
Online ISSN : 2186-2494
Print ISSN : 1882-4072
ISSN-L : 1882-4072
Original Articles
Hyperperfusion Immediately after Reperfusion by Thrombectomy May Predict Hemorrhagic Transformation
Tomoyuki YoshiharaRyuzaburo KanazawaHidenori OhbuchiTakanori UchidaTetsuhiro HigashidaNaoyuki AraiManabu OsakabeYuichi Takahashi
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ジャーナル オープンアクセス

2019 年 13 巻 4 号 p. 149-154

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Objective: To evaluate cerebral blood flow immediately after reperfusion following thrombectomy for acute large vessel occlusion, and to examine whether cerebral blood flow after reperfusion is related to hemorrhagic transformation.

Methods: The patients with acute large vessel occlusion in the anterior circulation who obtained reperfusion by thrombectomy were included. Cerebral blood flow was evaluated using single photon emission computed tomography (SPECT) within 6 hours after reperfusion. The patients were divided into two groups with or without hemorrhagic transformation, and basic characteristics, the ratio of cerebral blood flow (affected-side to unaffected-side ratio) in the perfusion area of the middle cerebral artery (MCA asymmetry index), and functional prognosis were compared among two groups.

Results: In all, 23 patients were included; 11 presented hemorrhagic transformation, and 12 did not. The hemorrhagic group exhibited significantly higher MCA asymmetry index than the non-hemorrhagic group (median: 1.54 [1.30–1.83] vs. 1.12 [1.07–1.24], respectively, P = 0.02), and a lower rate tendency of modified Rankin Scale (mRS): 0-2 after 3 months (1 patient [9%] vs. 6 patients [50%], respectively, P = 0.06).

Conclusion: In patients with successful reperfusion by thrombectomy, hemorrhagic transformation is predisposed to occur when high MCA asymmetry index is presented. Care should be taken in periprocedural management of blood pressure and sedation for those with high MCA asymmetry index.

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© 2019 The Japanese Society for Neuroendovascular Therapy

This article is licensed under a Creative Commons [Attribution-NonCommercial-NoDerivatives 4.0 International] license.
https://creativecommons.org/licenses/by-nc-nd/4.0/
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