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P93 Introduction: The availability of reperfusion  therapy for acute ischemic stroke patients has made the causes and  significance of hemorrhagic transformation an area of intense interest  and controversy.Methods: Seventy-four male Wistar rats  underwent temporary middle cerebral artery occlusion (MCAO) of between  1 and 6 hours. Twenty-two animals received 10 mg/kg of tissue  plasminogen activator (tPA), infused over 20 minutes, starting 5  minutes before reperfusion. At 18–24 hours, the animals were  sacrificed and tissue collected for analysis. The presence of grossly  observable hemorrhagic transformation (HT)was recorded and total  ischemic lesion area was quantified using image analysis software  (Zeiss - KS 300). Stepwise logistic regression was used to quantify the  important contributors to HT development.Results: Thirty  animals developed HT. The development of HT was significantly  associated with occlusion duration (p=0.0004),with every hour of delay  increasing the risk of HT by 1.9. The times associated with 25%,50%  and 75% HT were 2.5, 4 and 5.5.hours, respectively. Infarct size (sum  of lesion areas) was also signficantly associated with HT (p=0.02) but  in the step wise regression, neither infarct size nor tPA contributed  significantly to the model. The overall predictive value of the model  was 77% but it was higher (81%) when predicting no HT.Conclusions: Duration of occlusion is a more important  predictor of HT than either the infarct size or the presence of tPA in  temporary MCAO in the rat. Duration of occlusion most closely predicts  the degree of damage to the vasculature necessary for the development  of HT.

Hemorrhagic Transformation: Influence of occlusion duration, infarct size and tissue plasminogen activator in experimental stroke