BACKGROUND Anecdotal cases of exophthalmos after acute mechanical thrombectomy have been described. We sought to estimate the incidence in a large cohort of patients with acute anterior circulation stroke treated with mechanical thrombectomy. Secondarily, we aimed to evaluate the underlying mechanism and to differentiate it on imaging from other pathology with similar clinical orbital features. METHODS Between November 2016 and November 2018, we performed a retrospective single-center study of 250 patients who underwent anterior circulation mechanical thrombectomy. Development of exophthalmos was independently evaluated by two readers on preprocedure and 24-h postprocedure non-contrast cerebral CT. RESULTS In the mechanical thrombectomy cohort, six individuals (2.4%) developed interval ipsilateral exophthalmos at 24 h. Of these, at least two patients developed clinical symptoms. There was almost perfect agreement between assessments of the two readers (Cohen's kappa = 0.907 (95% confidence interval: 0.726, 1.000)). In two patients, there was delayed ophthalmic artery filling on digital subtraction angiography. None of the patients had features of a direct carotid-cavernous fistula. CONCLUSIONS Exophthalmos is not uncommon after mechanical thrombectomy (2.4%). The underlying mechanism is difficult to confirm, but it is most likely due to orbital ischemia from hypoperfusion or distal emboli.

中文翻译：

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前循环卒中机械取栓术后眼球突出：回顾性研究和文献复习。

背景 已经描述了急性机械取栓后眼球突出的轶事案例。我们试图估计大量接受机械取栓治疗的急性前循环卒中患者的发病率。其次，我们旨在评估潜在的机制，并将其与具有相似临床眼眶特征的其他病理学区分开来。方法 2016 年 11 月至 2018 年 11 月，我们对 250 名接受前循环机械取栓术的患者进行了回顾性单中心研究。由两名阅片者在术前和术后 24 小时非对比脑 CT 上独立评估眼球突出的发展。结果 在机械取栓队列中，6 人 (2.4%) 在 24 小时内出现间隔性同侧眼球突出。这些，至少有两名患者出现了临床症状。两位读者的评估结果几乎完全一致（Cohen's kappa = 0.907（95% 置信区间：0.726, 1.000））。在两名患者中，数字减影血管造影显示眼动脉充盈延迟。没有患者具有直接颈动脉海绵窦瘘的特征。结论 机械取栓后眼球突出并不少见 (2.4%)。其潜在机制难以确定，但最有可能是由于灌注不足或远端栓塞导致眼眶缺血所致。没有患者具有直接颈动脉海绵窦瘘的特征。结论 机械取栓后眼球突出并不少见 (2.4%)。其潜在机制难以确定，但最有可能是由于灌注不足或远端栓塞导致眼眶缺血所致。没有患者具有直接颈动脉海绵窦瘘的特征。结论 机械取栓后眼球突出并不少见 (2.4%)。其潜在机制难以确定，但最有可能是由于灌注不足或远端栓塞导致眼眶缺血所致。