Background The significance of early venous filling (EVF) after mechanical thrombectomy (MT) in acute ischemic stroke (AIS) is not fully understood. In this study, we aimed to investigate the impact of EVF after MT.
Methods From January 2019 to May 2022, AIS patients with successful recanalization (modified Thrombolysis in Cerebral Infarction score (mTICI) ≥2b) after MT were retrospectively reviewed. EVF was evaluated on final digital subtraction angiography runs after successful recanalization and was categorized into phase subgroups (arterial phase and capillary phase) and pathway subgroups (cortical veins subgroup and thalamostriate veins subgroup), respectively. The impact of EVF subgroups on functional outcomes after successful recanalization were both investigated.
Results A total of 349 patients achieving successful recanalization after MT were included, including 45 patients in the EVF group and 304 patients in the non-EVF group. Multivariable logistic regression analysis showed the EVF group had a higher rate of intracranial hemorrhage (ICH; 66.7% vs 22%, adjusted odds ratio (aOR) 6.805, 95% CI 3.389 to 13.662, P<0.001), symptomatic ICH (sICH; 28.9% vs 4.9%, aOR 6.011, 95% CI 2.493 to 14.494, P<0.001) and malignant cerebral edema (MCE; 20% vs 6.9%, aOR 2.682, 95% CI 1.086 to 6.624, P=0.032) than the non-EVF group. Furthermore, the cortical veins subgroup of EVF had a higher rate of mortality than the thalamostriate veins subgroup (37.5% vs 10.3%, P=0.029).
Conclusions EVF is independently associated with ICH, sICH and MCE after successful recanalization of MT, but not with favorable outcome and mortality.
Data availability statement
Data are available upon reasonable request.
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YL and WC are joint first authors.
YL and WC contributed equally.
XB and LJ contributed equally.
Contributors YL, WC, XX, TL, XB, YL, CW and LJ participated in the designation and conceptualization of this study. WC, XB and YL conducted data curation and statistical analysis. YC, YW, JC, PG, BY, FC and QM provided clinical data. JL provided imaging data. YL, WC, XX, TL, YC, YW, JC, PG, BY, FC and QM drafted and collated the manuscript. YL, WC, AAD, RWR, JL, YL, CW, XB and LJ edited and revised the manuscript. All the authors read and finally approved the published manuscript, and are responsible for ensuring the accuracy and completeness of the work. Liqun Jiao was specified as the guarantor of the manuscript and responsed for the overall content.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.