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Introduction The relationship between the presence and burden of cerebral microbleeds (CMBs) and the occurrence of hemorrhagic transformation following successful recanalization in patients diagnosed with acute ischemic stroke resulting from large vessel occlusion (LVO) has been reported.Aim of Study This prospective cohort study aimed to investigate the relationship between CMBs and hemorrhagic transformation following thrombectomy.Method Total of 132 patients with acute ischemic stroke with successful recanalization by thrombectomy for emergent LVO, were enrolled in this study. CMBs and HT assessed using T2-MRI with a validated scale. The primary outcome measure was the occurrence of HT following thrombectomy. The secondary outcome was defined as a poor functional outcome, with mRS ranging from 3 to 6, assessed at 3 months after stroke onsetResults Among 132 patients, 24 (18.2%) exhibited CMBs, and 59 (44.7%) developed HT. A total of 47 (49.2%) experienced a poor functional outcome, and the mortality rate was 11.3%. Statistical analysis revealed a significant association between the presence of CMBs and the occurrence of HT after successful thrombectomy (77.8% vs. 38.9%; P=0.002). Moreover, the presence of CMBs was significantly correlated with a higher likelihood of a poor functional outcome (77.8% vs. 42.9%; P=0.007) after adjustment of initial stroke severity and diffusion lesion volume. However, there was no observed association between the presence of CMBs and mortality (16.7% vs. 8.25%; P=0.426).Abstract A20 Table 1Abstract A20 Figure 1Conclusion The presence of CMBs is significantly associated with the occurrence of HT and a poor functional outcome following successful thrombectomy. However, it does not appear to impact mortality rates in these patientsConflict of Interest No