Blood glucose level on ER arrival is associated with hemorrhagic conversion, according to intravenous thrombolysis, in patients with successful Recanalization by mechanical thrombectomy.

초록

Purpose : Elevated blood glucose level(BGL) is known to be related to hemorrhagic conversion(HC) after reperfusion therapy. There is some difference in relationship of HC and BGL between intravenous thrombolysis and endovascular treatment(EVT). However, the effect of BGL on HC, according to intravenous thrombolysis remains uncertain, especially in patients with successful recanalization after EVT.Methods : A consecutive 211 patients with occlusion of major cerebral artery and successful recanalization from three centers were included for the analysis between 2013 and 2017. The information on the clinical findings was reviewed retrospectively. We compared the association of blood BGL and HC, between group of mechanical thrombectomy only and combined therapy. Results : Among the included patients, 23 patients (10.9%) developed major HC over the first 24 hours after successful recanalization. Univariate analysis showed that fasting BGL was associated with HC and BGL on ER arrival had the tendency to increased HC among total patients enrolled. The history of diabetes mellitus was not related to HC. Among the patients with intravenous thrombolysis and EVT, the HC had the tendency to the high fasting glucose level, although initial BGL was not related. However, among the patients with EVT only, the incidence of HC was higher in the patients with high BGL on ER arrival with marginal significance. Conclusions : Our results suggested that the effect of serum glucose level on HC was different according to the intravenous thrombolysis treatment, in the patients with recanalization after EVT. In the patients with intravenous thrombolysis, the control of BGL during the intravenous actylase infusion might be more important for the prevention of HC.