title: Hemorrhage/contrast staining areas after mechanical intra-arterial thrombectomy in acute ischemic stroke: imaging findings and clinical significance.
abstract: OBJECTIVE
  The aim of this study was to report the CT evolution and clinical significance of HCA after intra-arterial mechanical thrombectomy (revascularization by using retrievers and/or other mechanical devices without concomitant delivery of intra-arterial thrombolytics) in our patients. These lesions are common after intra-arterial thrombolysis, being considered a negative prognostic sign. Their significance after pure mechanical thrombectomy remains unknown.
  
  
  METHODS
  Forty-eight patients were treated with mechanical thrombectomy by using retrievable stents between April 2010 and February 2011. All patients underwent initial (first 24 hours) and follow-up (48-72 hours) nonenhanced CT. We retrospectively analyzed the clinical and radiologic data of the patients with HCA and compared them with controls.
  
  
  RESULTS
  Fifteen of 48 patients presented with HCA. The site of occlusion was the MCA in 7 patients, both the extra- and intracranial segments of the ICA in 6, and the intracranial ICA in 2. In 7 patients, previous intravenous thrombolysis was administered. Complete recanalization (TICI 3) was achieved in 12 patients, and incomplete recanalization (TICI 2b), in 3. The location of HCA was the subarachnoid space in 6 patients, the brain parenchyma in 4 patients, and both in 5 patients. The HCA were asymptomatic in all patients. There was no statistical difference in final NIHSS score reduction (NIHSS pretreatment-NIHSS at discharge) between patients and controls.
  
  
  CONCLUSIONS
  In our series, HCA are common after mechanical thrombectomy but do not carry an increased risk of symptomatic hemorrhage or negative prognosis. These data might be related to the high rate of recanalization and the absence of intra-arterial thrombolytics.
authors.affiliation: Department of Interventional Neuroradiology, Hospital Universitario Virgen de la Arrixaca, Carretera Murcia-Cartagena, S/N, El Palmar, Murcia, Spain. gpr1972@gmail.com
authors.forename: G
authors.initials: G
authors.lastname: Parrilla
authors.forename: B
authors.initials: B
authors.lastname: García-Villalba
authors.forename: M
authors.initials: M
authors.lastname: Espinosa de Rueda
authors.forename: J
authors.initials: J
authors.lastname: Zamarro
authors.forename: E
authors.initials: E
authors.lastname: Carrión
authors.forename: F
authors.initials: F
authors.lastname: Hernández-Fernández
authors.forename: J
authors.initials: J
authors.lastname: Martín
authors.forename: R
authors.initials: R
authors.lastname: Hernández-Clares
authors.forename: A
authors.initials: A
authors.lastname: Morales
authors.forename: A
authors.initials: A
authors.lastname: Moreno
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002533:Cerebral Angiography / Q000379:methods*; D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging* / Q000209:etiology* / Q000517:prevention & control; D003287:Contrast Media; D005260:Female; D006801:Humans; D002546:Ischemic Attack, Transient / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery*; D008297:Male; D061185:Mechanical Thrombolysis / Q000009:adverse effects*; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media