Analysis of intracranial cerebral hemorrhage in patients after receiving rescue thrombectomy with Solitaire AB stent for acute ischemic stroke / 介入放射学杂志

ABSTRACT

Objective To discuss the influencing factors of intracranial cerebral hemorrhage complicationin patients with acute ischemic stroke (AIS) after receiving Solitaire AB stent mechanical thrombectomy.Methods The clinical data of 32 AIS patients,who were treated with Solitaire AB stent thrombectomy during the period from June 2015 to October 2016 at authors' hospital,were retrospectively analyzed.The basic materials of patients,who developed intracranial hemorrhagic transformation (HT) after Solitaire AB stent thrombectomy,were analyzed and compared with the results of related studies published at home and abroad.Results Solitaire AB stent thrombectomy was successfully accomplished in all the 32 AIS patients.The postoperative fatality rate was 9.4％ (3/32).Three patients developed symptomatic intracranial HT after Solitaire AB stent thrombectomy,including artery occlusion in anterior circulation (n=1) and artery occlusion in posterior circulation (n=2),with the HT incidence being 9.4％ (3/32).Of the 3 patients,conservative treatment was adopted in 2 and ventricular external drainage with implantation of liquid storage bag through ventricular drilling-hole was carried out in one.Finally,2 patients died of HT and one patient recovered by conservative treatment.The percentage of HT death patients in all deaths was 66.7％ (2/3).Conclusion Intracranial HT is a fatal complication of embolectomy in AIS patients.In clinical practice,the indications of thrombectomy should be strictly observed,besides,intraoperative fine manipulation and sandardized perioperative management are also very important to reduce the incidence of bleeding complications.