急性缺血性脑卒中取栓术后出血转化相关因素研究进展

Research progress in the related factors of hemorrhagic transformation in patients with acute ischemic stroke after thrombectomy

机械取栓是目前大血管闭塞所致急性缺血性脑卒中(AIS)最有效的再通治疗方法,其安全性和有效性已由多项研究证实。随着机械取栓技术逐渐普及,出血转化(HT)发生及其相关因素也受到广泛关注。HT是机械取栓术后主要并发症之一,可能降低甚至抵消取栓治疗获益,增加AIS患者病死率。HT与临床不良预后直接相关。该文就大血管闭塞性AIS患者机械取栓术后HT发生机制、分型、影像学评估及危险因素等研究现状作一综述,为神经介入医师评估术后HT风险、筛选适合机械取栓患者、预防HT发生提供参考。

Mechanical thrombectomy(MT)has been the most effective treatment for acute ischemic stroke(AIS)caused by large vessel occlusion,and its safety and effectiveness have already been confirmed by many studies.With the gradual popularization of MT technique,the hemorrhagic transformation(HT)and its relevant factors have also attracted wide attention.HT is one of the main postoperative complications,which may reduce or even clear up the therapeutic benefit of MT and increase the mortality.HT is directly related to poor clinical prognosis.This article aims to make a comprehensive review about mechanism,typing,imaging evaluation and risk factors of HT in patients with AIS caused by large vessel occlusion after MT treatment,so as to provide reference for neurointerventional physicians to assess postoperative risk of HT,select patients suitable for MT,and prevent the occurrence of HT.(J Intervent Radiol,2022,31:310-314)