Retrospective analysis of consecutive acute ischemic stroke(AIS) patients undergoing MT between 02/2015-07/2017 at CSC. Covariates included age, sex, comorbidities, baseline antiplatelet and anticoagulant use, baseline INR and creatinine, baseline NIHSS, IV-rtPA or IA-rtPA administration, time-to-treatment(DTN, DTP and OTP), number of passes, TICI, highest-SBP in 24hour. Outcome measures included radiological-hemorrhagic-transformation(RHT) and symptomatic-hemorrhagic-transformation(sICH). sICH was defined as RHT with worsening of 4points in 24-36h NIHSS(ECASS II criteria) and by atleast 1point(NINDS criteria). Neuroradiology official report was used to define RHT. RHT was further classified according to Heidelberg-bleeding-classification as HI1, HI2, PH1, PH2 and SAH.

180 cases were analyzed, with mean age 72.8±13.8years including 50% women, 124 White, 47 African-American and 46% Hispanic. 72 were on antiplatelet agents(68 single agent, 4 dual) and 30 were on anticoagulants(13 warfarin, 16 NOAC, 1 IV-heparin). Mean baseline NIHSS was 16.4±6.2. IV-rtPA was administered to 106, and 60 received IA-rtPA. RHT was present in 54(30%): HI1 in 17, HI2 in 20, PH1 in 5, PH2 in 6, SAH in 6, SAH with or without RHT in 11. sICH with ?4 NIHSS-point-deterioration was present in 10(5.6%), and sICH with ?1 NIHSS-point-deterioration in 19(10.6%). On multivariate analysis, factors associated with RHT were BMI(p=0.02, OR 1.73), smoking(p=0.04, OR 3.9), intra-operative therapeutic heparin administration(p=0.056, OR 5.6), number of passes(p=0.085, OR 1.35) and OTP >6h(p=0.068, OR 2.76). Whereas, IV-tPA(p=0.173) or IA-tPA administration with MT(p=0.252) are not associated with increased rate of RHT.