Higher Hypoperfusion Index Ratio Linked to Increased Risk of Hemorrhagic Transformation After Mechanical Thrombectomy

Strategic Insights -

Researchers at Valley Baptist Medical Center have investigated the relationship between hypoperfusion index ratio (HIR) and the rate of hemorrhagic transformation in patients undergoing mechanical thrombectomy for large vessel occlusion (LVO) stroke. The study, published in Interventional Neuroradiology, found that a higher HIR on admission computed tomography perfusion (CTP) scans was associated with an increased risk of hemorrhagic transformation. The study's findings suggest that HIR could be used as a predictor for hemorrhagic transformation after mechanical thrombectomy.

Key Takeaways:

  • The study included 289 patients who underwent mechanical thrombectomy for LVO stroke between January 2019 and December 2022.
  • 55 (19%) of patients developed hemorrhagic transformation, with a significantly higher HIR (median 0 vs 0.2) compared to those without hemorrhagic transformation (p = 0.004).
  • Multivariable analysis showed that for every 0.1 increase in HIR, there was a 4.64-fold increase in hemorrhagic transformation (OR 4.64; 95% CI 1.40 to 15.18; p = 0.011).
  • The study concluded that HIR could be used as a predictor for hemorrhagic transformation after mechanical thrombectomy.
  • The study's results have important implications for the management of LVO stroke and the development of predictive models for hemorrhagic transformation.

Statistics:

  • 289 patients were included in the study.
  • 55 (19%) of patients developed hemorrhagic transformation.
  • The median HIR in patients with hemorrhagic transformation was 0.2, compared to 0 in patients without hemorrhagic transformation (p = 0.004).
  • For every 0.1 increase in HIR, there was a 4.64-fold increase in hemorrhagic transformation (OR 4.64; 95% CI 1.40 to 15.18; p = 0.011).

Sources:

  • NewsRx. Studies from Valley Baptist Medical Center Have Provided New Data on Neuroradiology (On old dogs and new tricks: CT perfusion predicts hemorrhagic transformation after thrombectomy). Pain & Central Nervous System Week. October 20, 2025; p 1827.
  • Interverventional Neuroradiology. "On old dogs and new tricks: CT perfusion predicts hemorrhagic transformation after thrombectomy." 2025:15910199251386104.