Location of the contrast extravasation is important in predicting outcome of anterior circulation stroke patients

Abstract

Objectives: Contrast extravasations (CE) are frequently seen on postprocedural computed tomography after endovascular therapy (EVT). This study aimed to investigate the relationship between patients’ outcomes and CE after EVT.

Methods: Stroke patients who had received EVT between 2019 and 2021 were reviewed retrospectively. The CEs were mapped using MRIcroGL software. The rate of in-hospital mortality and modified Rankin Scale at 90 days were taken as outcome measures. Stepwise logistic regression analyses were performed. Three models were created with and without pure CE to predict the patients’ outcomes.

Results: There were 126 patients included in the study. According to the univariable analysis, CE (OR = 0.70, 95% CI = 0.18–2.68, P = 0.26) and CE-ASPECTS (OR = 1.21, 95% CI=0.60-2.44, P = 0.57) were not related with in-hospital mortality after EVT. The lesion mapping showed that the most common CE locations among the patients with a poor prognosis was the M6 area. The multivariable logistic regression analysis showed that CE in the M6 area (OR = 6.87, 95% CI = 1.27–144.92, P = 0.006) increased the risk of a 3-month poor outcome. The study showed that adding CE to the well-known risk factors for poor prognosis improves the predictive power of the models (ΔAUC of 0.07, P = 0.02).

Conclusion: CE has a prognostic value after EVT in anterior stroke patients. The prognostic value is the highest when present in the M6 area.