Introduction: Elevated blood glucose level(BGL) is known to be related to hemorrhagic transformation (HT) after reperfusion therapy. However, the effect of BGL on HT, according to intravenous thrombolysis remains uncertain, especially in patients with successful recanalization after mechanical thrombectomy. 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 HT, between group of mechanical thrombectomy only and combined therapy. Result: Among the included patients, 23 patients (10.9%) developed major HT over the first 24 hours after successful recanalization. Univariate analysis showed that fasting BGL was associated with HT and BGL on ER arrival had the tendency to increased HT among total patients enrolled. The history of diabetes mellitus was not related to HT. Among the patients with intravenous thrombolysis and mechanical thrombectomy, the HT had the tendency to the high fasting glucose level, although initial BGL was not related. However, among the patients with mechanical thrombectomy only, the incidence of HT 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 HT was different according to the intravenous thrombolysis treatment, in the patients with recanalization after mechanical thrombectomy. In the patients with intravenous thrombolysis, the control of BGL during the intravenous actylase infusion might be more important for the prevention of HT.
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