ABSTRACT NUMBER: ESOC2026A1193 PREDICTIVE FACTORS OF HEMORRHAGIC TRANSFORMATION AND CLINICAL OUTCOMES IN PATIENTS UNDERGOING ANTERIOR CIRCULATION THROMBECTOMY: DATA FROM A COMPREHENSIVE STROKE CENTER IN VIETNAM

Abstract Background and aims Hemorrhagic transformation (HT) is a common complication after mechanical thrombectomy. This study aimed to evaluate predictive factors of HT and outcome predictors among patients undergoing anterior circulation thrombectomy Methods A retrospective analysis was conducted on 244 patients with ischemic stroke who underwent anterior circulation thrombectomy from June 2022 to May 2023. Clinical, laboratory, and imaging data were collected and compared between groups with and without HT, as well as between those with and without symptomatic transformation (sICH). Additionally, characteristics within the HT group were compared by outcome. Univariate and multivariate regression analyses were performed with a significance threshold of <0.05 Results HT and sICH occurred in 38.5% and 10% of patients, respectively. HT and sICH patients had lower ASPECTS scores, higher rates of cardioembolic stroke etiology, and elevated white blood cell and neutrophil counts. Cardioembolic source was independently associated with HT and sICH (OR 2.39, 95% CI: 1.31–4.36 and OR 3.14, 95% CI: 1.11–8.88, respectively). TICI 2b-3 recanalization (OR 2.51, 95% CI: 1.09–5.77) was associated with HT but not with sICH. Conversely, ICA occlusion was independently linked to sICH (OR 3.87, 95% CI: 1.30–11.50). Age (OR 0.86, 95% CI: 0.78-0.95) and 24-hour NIHSS (OR 0.62, 95% CI: 0.43-0.88) were independent predictors of good outcomes in the HT group Conclusions HT predictors include cardioembolic etiology and TICI 2b-3 recanalization, whereas predictors of sICH include cardioembolic etiology and ICA occlusion. Younger age and lower 24-hour NIHSS scores are associated with better outcomes in the HT group. Conflict of interest Tho Pham-Quang: nothing to disclose. Phuong Dao: nothing to disclose. Duy-Ton Mai: nothing to disclose. Dung Nguyen-tien: nothing to disclose. linh pham: nothing to disclose. bui quoc viet: nothing to disclose.