ABSTRACT
Objective To analyze the characteristics of local brain tissue flat-panel CT high-density sign in mechanical thrombectomy for acute ischemic stroke with large vessel occlusion anil the effect on the hemorrhagic transformation and prognosis of patients. Methods From September 2013 to March 2018, a total of 244 consecutive patients (64 posterior circulation lesions) with acute ischemic stroke of large vessel occlusion treated with mechanical thrombectomy, checked by intraoperative flat-panel CT and admitted to the Department of Cerebrovascular Disease Center, First Hospital Affiliated to Naval Military Medical University were enrolled retrospectively. Eighty-five of them were treated with bridging treatment. According to whether the findings of flat-panel CT having local high-density sign or not,they were divided into either a high-density sign group (n =71) or a non-high-density sign group (n = 173). The inter-group differences of the baseline data of both groups (sex,age,preoperative National Institutes of Health Stroke Scale [N1HSS] score),clinical data (bridge treatment,occlusion site,revascularization reaching the modified treatment in cerebral infarction [mTICI] grade 2b-3,good prognosis at 90 d after procedure,hemorrhagic transformation, and mortality) were documented and analyzed. The distribution characteristics of high-density signs of intraoperative flat CT were analyzed. Univariate and multivariate logistic regression analyses of tlie hemontiagic transformation and good prognosis in the high-density group were evaluated. Results (1) The preoperative NIHSb score of the high density sign group was higher than that of the non-hjgh density sign group. There was significant difference between the two groups (20[15,23] vs. I7( 10,22] ,Z = 5. 454,/' =0.028). There were no significant differences in other baseline data between the two groups (all P > 0. 05). (2) The occlusion ratio of T-shaped and l.-shaped internal carotid artery and Ml segment of middle cerebral artery in the high-density sign group were higher than those in the non-high-density sign group (36. 6% [26/71 ] w. 22. 5% [39/173] ,50.7% [36/71 ] vs. 35. 3% [61/173] ) ,and the occlusion ratio of vertebrobasilar artery was lower than that in the non-high-density sign group (5.6% [4/71] vs. 31.2% [54/173] ). There was significant difference between the two groups (all P en