Association Between Peripheral Arterial Lactate Levels and Malignant Brain Edema Following Endovascular Treatment for Ischemic Stroke

Overview

Journal Curr Neurovasc Res

Publisher Bentham Science Publishers

Specialties Cardiology & Vascular Diseases
Neurology

Date 2024 Jul 15

PMID 39004958

Authors

Huiyuan Wang

Ruozhen Yuan

Panpan Shen

Xinyue Yu

Xinyi Chen

Yafei Shang

Jie Xu

Mingming Tan

Sheng Zhang

Yu Geng

Affiliations

Soon will be listed here.

Abstract

Aims: To investigate the factors of postoperative malignant brain edema (MBE) in patients with acute ischemic stroke (AIS) treated with endovascular treatment (EVT).

Background: MBE is a severe complication following EVT for AIS, and it is essential to identify risk factors early. Peripheral arterial lactate (PAL) levels may serve as a potential predictive marker for MBE.

Objective: To determine whether immediate postoperative PAL levels and the highest PAL level within 24 hours of EVT are independently associated with MBE development in AIS patients.

Methods: We retrospectively analyzed patients with AIS who underwent EVT from October 2019 to October 2022. Arterial blood was collected every 8 h after EVT to measure PAL, and record the immediate postoperative PAL and the highest PAL level within 24 h. Brain edema was evaluated using brain computed tomography scans within 7 days of EVT.

Results: The study included 227 patients with a median age of 71 years, of whom 59.5% were male and MBE developed in 25.6% of patients (58/227). Multivariate logistic regression analysis showed that the immediate postoperative PAL (odds ratio, 1.809 [95% confidence interval (CI), 1.215-2.693]; p = 0.004) and the highest PAL level within 24 h of EVT (odds ratio, 2.259 [95% CI, 1.407-3.629]; p = 0.001) were independently associated with MBE. The area under the curve for predicting MBE based on the highest PAL level within 24 hours of EVT was 0.780 (95% CI, 0.711-0.849).

Conclusion: Early increase in PAL levels is an independent predictor of MBE after EVT in AIS patients.

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