Contrast enhancement after mechanical thrombectomy: clinical correlations and impact on outcomes


Khasiyev F., Rodriguez W., Kaur G., Allahverdiyev I., Miremadi B., Christopher K., ...More

Acta Neurologica Belgica, vol.125, no.1, pp.133-139, 2025 (SCI-Expanded) identifier identifier

  • Publication Type: Article / Article
  • Volume: 125 Issue: 1
  • Publication Date: 2025
  • Doi Number: 10.1007/s13760-024-02671-1
  • Journal Name: Acta Neurologica Belgica
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE
  • Page Numbers: pp.133-139
  • Keywords: Acute ischemic stroke, Blood-brain barrier, Clinical outcomes, Contrast enhancement, Mechanical thrombectomy
  • Istanbul University Affiliated: No

Abstract

Purpose: Contrast enhancement (CE) after mechanical thrombectomy (MT) remains a subject of investigation, with a reported prevalence ranging from 31 to 88%. We examined our patients to identify predictors of CE and its impact on outcomes, an aspect that remains understudied. Methods: We retrospectively analyzed 106 patients who underwent MT at our hospital between 2018 and 2022. The inclusion criteria involved patients who underwent two head CT scans: one immediately after the procedure and a repeat scan within 24 h. This study compared demographic, clinical, laboratory, neuroimaging, and procedure-related variables between patients with CE and those without hyperdensity. Regression analysis was employed to determine the associations between CEs and significant variables. Results: Among the analyzed patients, 32.1% had CE. Hyperlipidemia was more prevalent in the CE group. CE correlated with an increase in the National Institutes of Health Stroke Scale (NIHSS) score ≥ 4 within 24 h, intracerebral hemorrhage (ICH) incidence, elevated NIHSS score, and a decreased rate of modified Rankin scale (mRS) 0–3 upon discharge. The adjusted model demonstrated a significant association between CE and the incidence of hyperlipidemia and ICH, with an increase in NIHSS score ≥ 4 within 24 h of ICH and a lower mRS score of 0–3 upon discharge. Conclusions: CE is associated with hyperlipidemia, ICH, early neurological deterioration, and poor functional outcomes upon discharge. However, no similar association was shown for long-term outcomes. Further studies are required to clarify the pathophysiology of CE and its implications for optimizing stroke care.