scholarly journals Vitreous hemorrhage of unknown origin in adult non-diabetic non-traumatic eyes: a retrospective analysis and the lessons we learn from it

2021 ◽  
Vol 6 (7) ◽  
Keyword(s):  
Functional Outcome ◽  
Retrospective Analysis ◽  
Vitreoretinal Surgery ◽  
Vitreous Hemorrhage ◽  
Unknown Origin ◽  
Visual Outcome ◽  
Submacular Hemorrhage ◽  
Vessel Occlusion ◽  
Retinal Tear ◽  
Retinal Tears

Objective: To analyse the causes of vitreous hemorrhage (VH) of unknown origin in non-diabetic nontraumatic eyes and evaluate the results regarding the underlying cause and time of surgery. Methods and Analysis: Retrospective analysis of 125 eyes with a dense VH of unknown origin, who underwent vitrectomy at a varied time point. Preoperative and postoperative data were compared between the groups with the three major causes of VH as well as between the eyes with an early (≤5 days after presentation) and a late (>5 days after presentation) vitrectomy. Results: Most common causes of VH were retinal vessel occlusion (RVO; 39/125; 31.1%), retinal tears (36/125; 28.8%) and submacular hemorrhage (34/125; 27.2%). Postoperative visual acuity improved significantly in all eyes (2.14 vs. 1.04 logMAR, p<0.01) with better outcome in eyes with retinal tears. Early vitrectomy group had better functional outcome regardless of underlying cause (p=0.02). Final visual outcome correlated significantly with the underlying cause of VH (p<.001) and time to treatment in the retinal tear group (p<.001). Conclusion: We encourage performing early minimal invasive vitreoretinal surgery in cases of non-diabetic, non-traumatic VH. More than three of four of the cases are caused by retinal tear/retinal detachment, submacular hemorrhage and RVO. Early surgical treatment had better functional outcome on the longer run.

Internal limiting membrane graft as a treatment for the retinal detachment secondary to an optic disc coloboma

2021 ◽  
pp. 112067212199268
Author(s):  
Jorge Fernández-Engroba ◽  
Muhsen Saman ◽  
Jeroni Nadal
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
Optic Disc ◽  
Subretinal Fluid ◽  
Visual Outcome ◽  
Internal Limiting Membrane ◽  
Subretinal Space ◽  
Direct Closure ◽  
Retinal Tears ◽  
Optic Disc Coloboma

Purpose: To report our anatomical outcome with the internal limiting membrane (ILM) graft procedure in the management of rhegmatogenous retinal detachment (RRD) secondary to optic disc coloboma (ODC). Methods: Description of a new surgical procedure in one eye of one patient who underwent pars plana vitrectomy (PPV) combined with ILM graft technique. Subsequent follow-up included optical coherence tomography (OCT) and visual acuity. Results: After only 1 week, the OCT revealed the ILM graft plugging the retinal tear with complete resorption of subretinal fluid. The sealing effect of this graft persisted after 6 months. However, visual outcome was poor and corrected distance visual acuity was 20/200 as a result of the previous long-standing retinal detachment with loss of photoreceptors. Conclusion: We suggest that ILM graft could be performed as a first line treatment in the management of RRD secondary to ODC. This direct closure of the retinal tears, allows a quick and effective interruption of the communication between the subretinal space and the vitreous cavity. Detecting these retinal tears and applying this technique as soon as possible could achieve not only an earlier anatomical success but obtain good visual results in retinal tears with RRD secondary to ODC. Further studies will be necessary to provide more evidences

scholarly journals Bottlenecks in the Acute Stroke Care System during the COVID-19 Pandemic in Catalonia

2021 ◽  
pp. 1-9
Author(s):  
Anna Ramos-Pachón ◽  
Álvaro García-Tornel ◽  
Mònica Millán ◽  
Marc Ribó ◽  
Sergi Amaro ◽  
...  
Keyword(s):  
Acute Stroke ◽  
Functional Outcome ◽  
Stroke Care ◽  
Care Quality ◽  
Point Of View ◽  
Stroke Severity ◽  
Acute Stroke Care ◽  
Vessel Occlusion ◽  
Prehospital Delays ◽  
The Impact

<b><i>Introduction:</i></b> The COVID-19 pandemic resulted in significant healthcare reorganizations, potentially striking standard medical care. We investigated the impact of the COVID-19 pandemic on acute stroke care quality and clinical outcomes to detect healthcare system’s bottlenecks from a territorial point of view. <b><i>Methods:</i></b> Crossed-data analysis between a prospective nation-based mandatory registry of acute stroke, Emergency Medical System (EMS) records, and daily incidence of COVID-19 in Catalonia (Spain). We included all stroke code activations during the pandemic (March 15–May 2, 2020) and an immediate prepandemic period (January 26–March 14, 2020). Primary outcomes were stroke code activations and reperfusion therapies in both periods. Secondary outcomes included clinical characteristics, workflow metrics, differences across types of stroke centers, correlation analysis between weekly EMS alerts, COVID-19 cases, and workflow metrics, and impact on mortality and clinical outcome at 90 days. <b><i>Results:</i></b> Stroke code activations decreased by 22% and reperfusion therapies dropped by 29% during the pandemic period, with no differences in age, stroke severity, or large vessel occlusion. Calls to EMS were handled 42 min later, and time from onset to hospital arrival increased by 53 min, with significant correlations between weekly COVID-19 cases and more EMS calls (rho = 0.81), less stroke code activations (rho = −0.37), and longer prehospital delays (rho = 0.25). Telestroke centers were afflicted with higher reductions in stroke code activations, reperfusion treatments, referrals to endovascular centers, and increased delays to thrombolytics. The independent odds of death increased (OR 1.6 [1.05–2.4], <i>p</i> 0.03) and good functional outcome decreased (mRS ≤2 at 90 days: OR 0.6 [0.4–0.9], <i>p</i> 0.015) during the pandemic period. <b><i>Conclusion:</i></b> During the COVID-19 pandemic, Catalonia’s stroke system’s weakest points were the delay to EMS alert and a decline of stroke code activations, reperfusion treatments, and interhospital transfers, mostly at local centers. Patients suffering an acute stroke during the pandemic period had higher odds of poor functional outcome and death. The complete stroke care system’s analysis is crucial to allocate resources appropriately.

Surgical management and outcomes of pediatric open globe injuries requiring vitrectomy

2021 ◽  
pp. 112067212110006
Author(s):  
Xin Liu ◽  
Lufei Wang ◽  
Fengjuan Yang ◽  
Jia’nan Xie ◽  
Jinsong Zhao ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Surgical Management ◽  
Pediatric Patients ◽  
Vitreous Hemorrhage ◽  
Visual Outcome ◽  
Poor Visual Outcome ◽  
Early Vitrectomy ◽  
Open Globe ◽  
Time From Injury ◽  
Ocular Sign

Purpose: To describe surgical management and establish visual outcomes of open globe injury (OGI) in pediatric patients requiring vitrectomy. Methods: Forty-eight eyes of 48 pediatric patients underwent vitrectomy for OGI with secondary vitreoretinal complications in the eye center of Jilin University were included. Characteristics of patients, details of ocular examination and operation, presenting and final visual acuity were recorded. Results: Presenting visual acuity less than 20/400 was found in 44 eyes (91.7%), which included no light perception (NLP) in four eyes. At last visit, there was no eyes with visual acuity of NLP, and 19 eyes (39.6%) had a vision recovery to 20/400 or better. Mechanisms of injury, intraocular contents prolapse, presence of hyphema, intraocular foreign body, vitreous hemorrhage, retinal detachment, and total time from injury to PPV > 2 weeks were significant predictors of visual prognosis. Logistic regression analysis showed that hyphema was a significant predictive factor for poor visual outcome. Conclusion: Visual acuity was improved in most of the patients with OGI in this study. Hyphema is an important presenting ocular sign in estimating the post-vitrectomy visual outcome for OGI in children. Proper timing of vitrectomy is suggested, and in this study patients may benefit more with early vitrectomy as less proliferative vitreoretinopathy (PVR) was found together with a better visual acuity.

scholarly journals Platelet Activation and Chemokine Release Are Related to Local Neutrophil-Dominant Inflammation During Hyperacute Human Stroke

2021 ◽  
Author(s):  
Alexander M. Kollikowski ◽  
Mirko Pham ◽  
Alexander G. März ◽  
Lena Papp ◽  
Bernhard Nieswandt ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Platelet Activation ◽  
Prospective Observational Study ◽  
Self Control ◽  
Anterior Circulation ◽  
Vessel Occlusion ◽  
Platelet Counts ◽  
Arterial Blood ◽  
Human Stroke ◽  
Leukocyte Counts

AbstractExperimental evidence has emerged that local platelet activation contributes to inflammation and infarct formation in acute ischemic stroke (AIS) which awaits confirmation in human studies. We conducted a prospective observational study on 258 consecutive patients undergoing mechanical thrombectomy (MT) due to large-vessel-occlusion stroke of the anterior circulation (08/2018–05/2020). Intraprocedural microcatheter aspiration of 1 ml of local (occlusion condition) and systemic arterial blood samples (self-control) was performed according to a prespecified protocol. The samples were analyzed for differential leukocyte counts, platelet counts, and plasma levels of the platelet-derived neutrophil-activating chemokine C-X-C-motif ligand (CXCL) 4 (PF-4), the neutrophil attractant CXCL7 (NAP-2), and myeloperoxidase (MPO). The clinical-biological relevance of these variables was corroborated by specific associations with molecular-cellular, structural-radiological, hemodynamic, and clinical-functional parameters. Seventy consecutive patients fulfilling all predefined criteria entered analysis. Mean local CXCL4 (+ 39%: 571 vs 410 ng/ml, P = .0095) and CXCL7 (+ 9%: 693 vs 636 ng/ml, P = .013) concentrations were higher compared with self-controls. Local platelet counts were lower (− 10%: 347,582 vs 383,284/µl, P = .0052), whereas neutrophil counts were elevated (+ 10%: 6022 vs 5485/µl, P = 0.0027). Correlation analyses revealed associations between local platelet and neutrophil counts (r = 0.27, P = .034), and between CXCL7 and MPO (r = 0.24, P = .048). Local CXCL4 was associated with the angiographic degree of reperfusion following recanalization (r =  − 0.2523, P = .0479). Functional outcome at discharge correlated with local MPO concentrations (r = 0.3832, P = .0014) and platelet counts (r = 0.288, P = .0181). This study provides human evidence of cerebral platelet activation and platelet-neutrophil interactions during AIS and points to the relevance of per-ischemic thrombo-inflammatory mechanisms to impaired reperfusion and worse functional outcome following recanalization.

scholarly journals Hemodynamic Status During Endovascular Stroke Treatment: Association of Blood Pressure with Functional Outcome

2021 ◽  
Author(s):  
Min Chen ◽  
Dorothea Kronsteiner ◽  
Johannes Pfaff ◽  
Simon Schieber ◽  
Laura Jäger ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Standard Deviation ◽  
Functional Outcome ◽  
Scale Score ◽  
Endovascular Therapy ◽  
National Institutes Of Health ◽  
Modified Rankin Scale ◽  
Vessel Occlusion ◽  
Stroke Treatment ◽  
The Mean

Abstract Background Optimal blood pressure (BP) management during endovascular stroke treatment in patients with large-vessel occlusion is not well established. We aimed to investigate associations of BP during different phases of endovascular therapy with reperfusion and functional outcome. Methods We performed a post hoc analysis of a single-center prospective study that evaluated a new simplified procedural sedation standard during endovascular therapy (Keep Evaluating Protocol Simplification in Managing Periinterventional Light Sedation for Endovascular Stroke Treatment). BP during endovascular therapy in patients was managed according to protocol. Data from four different phases (baseline, pre-recanalization, post recanalization, and post intervention) were obtained, and mean BP values, as well as changes in BP between different phases and reductions in systolic BP (SBP) and mean arterial pressure (MAP) from baseline to pre-recanalization, were used as exposure variables. The main outcome was a modified Rankin Scale score of 0–2 three months after admission. Secondary outcomes were successful reperfusion and change in the National Institutes of Health Stroke Scale score after 24 h. Multivariable linear and logistic regression models were used for statistical analysis. Results Functional outcomes were analyzed in 139 patients with successful reperfusion (defined as thrombolysis in cerebral infarction grade 2b–3). The mean (standard deviation) age was 76 (10.9) years, the mean (standard deviation) National Institutes of Health Stroke Scale score was 14.3 (7.5), and 70 (43.5%) patients had a left-sided vessel occlusion. Favorable functional outcome (modified Rankin Scale score 0–2) was less likely with every 10-mm Hg increase in baseline (odds ratio [OR] 0.76, P = 0.04) and pre-recanalization (OR 0.65, P = 0.011) SBP. This was also found for baseline (OR 0.76, P = 0.05) and pre-recanalization MAP (OR 0.66, P = 0.03). The maximum Youden index in a receiver operating characteristics analysis revealed an SBP of 163 mm Hg and MAP of 117 mm Hg as discriminatory thresholds during the pre-recanalization phase to predict functional outcome. Conclusions In our protocol-based setting, intraprocedural pre-recanalization BP reductions during endovascular therapy were not associated with functional outcome. However, higher intraprocedural pre-recanalization SBP and MAP were associated with worse functional outcome. Prospective randomized controlled studies are needed to determine whether BP is a feasible treatment target for the modification of outcomes.

Abstract 1122‐000125: Underlying ICAD is Associated with Worse Outcome in Acute Large Vessel Occlusion Undergoing Endovascular Therapy

2021 ◽  
Vol 1 (S1) ◽  
Author(s):  
Sonam Thind ◽  
Ali Mansour ◽  
Scott Mendelson ◽  
Elisheva Coleman ◽  
James Brorson ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Intravenous Thrombolysis ◽  
Fold Increase ◽  
Large Vessel ◽  
High Risk Population ◽  
Large Vessel Occlusion ◽  
Vessel Occlusion ◽  
Nihss Score ◽  
Intracranial Atherosclerotic Disease ◽  
Poor Outcomes

Introduction : Acute large vessel occlusion (LVO) can be secondary to thromboembolism or underlying intracranial atherosclerotic disease (ICAD). Data on the management of LVO due to underlying ICAD are scarce. We hypothesized that patients with ICAD would have worse clinical outcomes following mechanical thrombectomy (MT) than those without ICAD. Methods : We performed a retrospective analysis of consecutive patients who underwent MT for LVO in a large academic comprehensive stroke center between 01/2018 and 05/2021. Presence of underlying ICAD at the site of LVO was determined by the treating interventionalist. We compared outcomes including in‐hospital mortality and 90‐day modified Rankin Scale (mRS) between those with and without underlying ICAD, adjusting for relevant covariates using logistic regression. Results : Among 195 patients (mean age 67.4+15.1 years, 56.9% female, 81% black, median NIHSS score 15), underlying ICAD was present in 39 (20.0%). Stent‐retrievers were used 196 patients with only 3 having rescue stent placement. There were no significant differences in baseline factors amongst the two groups except diabetes was more common (69.2% vs. 49.7%, p = 0.028) and intravenous thrombolysis provided less often (17.9% vs. 36.5%, p = 0.027) in those with ICAD. TICI 2B or higher was achieved in 82.1% of ICAD compared with 94.3% of non‐ICAD patients (p = 0.012). Mortality was more common (50.0% vs. 30.8%, p = 0.025) and good functional outcome (mRS 0–2) at 90 days was less common (10.8% vs. 30.0%, p = 0.002) in the ICAD group. Adjusting for age, diabetes, intravenous thrombolysis, baseline NIHSS score, and final TICI score, underlying ICAD was an independent predictor of mRS 0–2 at 90 days (OR 4.5, 95% CI 1.4‐14.2, p = 0.010). Conclusions : Underlying ICAD is associated with 4.5‐fold increase in poor functional outcome in patients with LVO undergoing traditional MT. Further research is needed to understand factors associated with poor outcomes investigate alternative interventional approaches and medical management in this high‐risk population.

Abstract P519: Higher Number of Thrombectomy Passes Significantly Increases Risk of Mass Effect, Poor Functional Outcome, and Mortality

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Victor M Ringheanu ◽  
Laurie Preston ◽  
WONDWOSSEN G TEKLE ◽  
Amrou Sarraj ◽  
Ameer E Hassan
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Functional Outcome ◽  
Internal Carotid ◽  
Mass Effect ◽  
Artery Occlusion ◽  
Delayed Presentation ◽  
Vessel Occlusion ◽  
Presentation Time ◽  
Poor Outcomes

Background: Endovascular treatment (EVT) is a widely proven method to treat patients diagnosed with intracranial large vessel occlusion (LVO). Through this method of treatment, it has been hypothesized that a lower number of thrombectomy passes is an indicator of higher rates of modified Thrombolysis in Cerebral Infarction 2b-3 (mTICI) and favorable outcomes defined as modified Rankin Scale 0-2 (mRS). Methods: Through the utilization of a prospectively collected endovascular database between 2012-2020, variables such as demographics, co-morbid conditions, intracerebral hemorrhage, mass effect, mortality rate, and good/poor outcomes in regard to mTICI score and mRS assessment at discharge were examined. The outcomes between patients receiving EVT who were treated with < 3 thrombectomy passes or ≥ 3 passes were compared. Results: Out of 454 patients treated with mechanical thrombectomy of qualifying intracranial internal carotid artery or middle cerebral artery occlusion, site of occlusion (internal carotid artery, M1 and M2), a total of 372 (81.9%) were treated with < 3 thrombectomy passes (average age 70.34 ± 13.75 years, 46.0% women), and 82 (18.1%) were treated with ≥ 3 thrombectomy passes (average age 70.30 ± 13.72 years, 48.8% women). Significantly higher rates of mass effect (p=0.043), mRS score 3-6 (p=0.029), and mortality (p=0.025) were noted in patients treated with ≥ 3 thrombectomy passes. Further analysis revealed that patients presenting 6-24 hours from symptom onset had significantly lessened chance of effective recanalization (TICI 2B-3; p=0.021). Conclusion: A higher number of thrombectomy passes, characterized as ≥ 3 passes in this study, was associated with significantly worsened patient outcome in regard to functional outcome, and mortality. Further research is required to determine whether the number of thrombectomy passes is an accurate indicator of treatment outcome and whether delayed presentation time increases risk of poor outcome.

Impact of Repeated Clot Retrieval Attempts on Infarct Growth and Outcome After Ischemic Stroke

Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000012321
Author(s):  
Wagih Ben Hassen ◽  
Caroline Touloupas ◽  
Joseph Benzakoun ◽  
Gregoire Boulouis ◽  
Martin Bretzner ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Stroke ◽  
Functional Outcome ◽  
Mechanical Thrombectomy ◽  
Binary Logistic Regression ◽  
Unfavorable Outcome ◽  
Binary Logistic Regression Analysis ◽  
Strongly Correlated ◽  
Vessel Occlusion

Objective:To determine whether the association between increasing number of clot retrieval attempts (CRA) and unfavorable outcome is due to an increase in emboli to new territory (ENT) and greater infarct growth (IG) in successfully recanalized patients with acute ischemic stroke due to large vessel occlusion (AIS LVO).Methods:Data were extracted from two pooled multicentric prospective registries of consecutive anterior AIS-LVO patients treated with mechanical thrombectomy (MT) between January 2016-2019. Patients with pretreatment and 24 hours post-treatment diffusion-weighted imaging (DWI) achieving successful recanalization, defined as expanded Thrombolysis in Cerebral Infarction Scale (eTICI) scores 2b, 2C or 3 were included. ENT were assessed and IG measured by voxel-based segmentation after DWI co-registration. Associations between number of CRA, ENT, IG and 3-month outcome were analyzed.Results:Four hundred nineteen patients achieving successful recanalization were included. ENT occurrence was strongly correlated with increasing CRA (ρ=0.73, p=10-4). In multivariable linear analysis, IG was independently associated with CRA (β=1.6 per retrieval attempt, 95% CI = [0.97–9.74], p=0.03) and ENT (β=2.7, [1.21-4.1], p=0.03). Unfavorable functional outcome (3-month modified Rankin Score >2) increased with each additional CRA. IG was an independent predictor of unfavorable outcome (OR=1.05 [1.02-1.07] per 1 mL IG increase, p=10-4) in binary logistic regression analysis.Conclusion:Increasing number of CRA in acute stroke is correlated with an increased ENT rate and increased IG volume, affecting functional outcome even when successful recanalization is achieved.Classification of evidence:This study provides Class II evidence that, for patients with acute stroke undergoing successful recanalization, an increasing number of clot retrieval attempts is associated with poorer functional outcome.

scholarly journals Value of infarct location in the prediction of functional outcome in patients with an anterior large vessel occlusion: results from the HERMES study

2021 ◽  
Author(s):  
Manon L. Tolhuisen ◽  
Marielle Ernst ◽  
Anne M. M. Boers ◽  
Scott Brown ◽  
Ludo F. M. Beenen ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Medical Management ◽  
Infarct Volume ◽  
Binary Logistic Regression ◽  
Brain Regions ◽  
Favorable Outcome ◽  
Vessel Occlusion ◽  
C Statistic ◽  
Strength Of Association

Abstract Purpose Follow-up infarct volume (FIV) is moderately associated with functional outcome. We hypothesized that accounting for infarct location would strengthen the association of FIV with functional outcome. Methods We included 252 patients from the HERMES collaboration with follow-up diffusion weighted imaging. Patients received endovascular treatment combined with best medical management (n = 52%) versus best medical management alone (n = 48%). FIV was quantified in low, moderate and high modified Rankin Scale (mRS)-relevant regions. We used binary logistic regression to study the relation between the total, high, moderate or low mRS-relevant FIVs and favorable outcome (mRS < 2) after 90 days. The strength of association was evaluated using the c-statistic. Results Small lesions only occupied high mRS-relevant brain regions. Lesions additionally occupied lower mRS-relevant brain regions if FIV expanded. Higher FIV was associated with a higher risk of unfavorable outcome, as were volumes of tissue with low, moderate and high mRS relevance. In multivariable modeling, only the volume of high mRS-relevant infarct was significantly associated with favorable outcome. The c-statistic was highest (0.76) for the models that included high mRS-relevant FIV or the combination of high, moderate and low mRS-relevant FIV but was not significantly different from the model that included only total FIV (0.75). Conclusion This study confirms the association of FIV and unfavorable functional outcome but showed no strengthened association if lesion location was taken into account.

Predictors of parenchymal hemorrhage after endovascular treatment in acute ischemic stroke: data from ANGEL-ACT Registry

2022 ◽  
pp. neurintsurg-2021-018292
Author(s):  
Dapeng Sun ◽  
Baixue Jia ◽  
Xu Tong ◽  
Peter Kan ◽  
Xiaochuan Huo ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Endovascular Treatment ◽  
Acute Ischemic Stroke ◽  
Functional Outcome ◽  
Multivariable Analysis ◽  
Serum Glucose ◽  
Chinese Patients ◽  
Anterior Circulation ◽  
Vessel Occlusion ◽  
Atherosclerotic Stenosis

BackgroundParenchymal hemorrhage (PH) is a troublesome complication after endovascular treatment (EVT).ObjectiveTo investigate the incidence, independent predictors, and clinical impact of PH after EVT in patients with acute ischemic stroke (AIS) due to anterior circulation large vessel occlusion (LVO).MethodsSubjects were selected from the ANGEL-ACT Registry. PH was diagnosed according to the European Collaborative Acute Stroke Study classification. Logistic regression analyses were performed to determine the independent predictors of PH, as well as the association between PH and 90-day functional outcome assessed by modified Rankin Scale (mRS) score.ResultsOf the 1227 enrolled patients, 147 (12.0%) were diagnosed with PH within 12–36 hours after EVT. On multivariable analysis, low admission Alberta Stroke Program Early CT score (ASPECTS)(adjusted OR (aOR)=1.13, 95% CI 1.02 to 1.26, p=0.020), serum glucose >7 mmol/L (aOR=1.82, 95% CI 1.16 to 2.84, p=0.009), and neutrophil-to-lymphocyte ratio (NLR; aOR=1.05, 95% CI 1.02 to 1.09, p=0.005) were associated with a high risk of PH, while underlying intracranial atherosclerotic stenosis (ICAS; aOR=0.42, 95% CI 0.22 to 0.81, p=0.009) and intracranial angioplasty/stenting (aOR=0.37, 95% CI 0.15 to 0.93, p=0.035) were associated with a low risk of PH. Furthermore, patients with PH were associated with a shift towards to worse functional outcome (mRS score 4 vs 3, adjusted common OR (acOR)=2.27, 95% CI 1.53 to 3.38, p<0.001).ConclusionsIn Chinese patients with AIS caused by anterior circulation LVO, the risk of PH was positively associated with low admission ASPECTS, serum glucose >7 mmol/L, and NLR, but negatively related to underlying ICAS and intracranial angioplasty/stenting.Trial registration numberNCT03370939.

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