Advances in experimental medicine and biology · 2026
Cerebral Edema Depends on the Results of Large Vascular Occlusion Reperfusion Therapy.
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Trofimov Alex O, Volkova Ekaterina, Nemoto Edwin M, Bragina Olga A, Bragin Denis E
Аннотация
UNLABELLED: The objective was to quantify the effect of endovascular therapy (EVT) results of large-vessel occlusion (LVO) on brain tissue hydration, assessed by net water uptake (NWU).
MATERIALS AND METHODS: Ninety-three patients with EVT of acute ischemic stroke (AIS) due to acute LVO (men-44, women-49, median age 68.7) were included in this retrospective, non-randomized, single-center study. EVT was performed under general anesthesia with approved devices, including a stent retriever and aspiration catheters. Net water uptake (NWU) in ischemic zones was evaluated using non-contrasted computed tomography (CT). NWU was calculated using the well-known formula in the symmetrical zone of the brain, in admission and follow-up non-contrasted CT scans, 24 h after EVT.
RESULTS: Fifty-seven patients had successful arterial recanalization (Thrombolysis in Cerebral Infarction scale [TICI] 2b-3), while 36 patients had persistent or recurrent acute LVO (TICI 0-2a). The NWU median at admission was 3.4% in patients with successful EVT and 5.1% in patients with unsuccessful EVT (p < 0.05). The follow-up NWU median was 7.2% after successful EVT and 12.8% in patients with persistent/recurrent acute LVO (p < 0.001).
CONCLUSION: Successful arterial recanalization at AIS due to LVO (TICI 2b -3) led to a significant reduction in brain edema progression in cerebral ischemic foci.
MATERIALS AND METHODS: Ninety-three patients with EVT of acute ischemic stroke (AIS) due to acute LVO (men-44, women-49, median age 68.7) were included in this retrospective, non-randomized, single-center study. EVT was performed under general anesthesia with approved devices, including a stent retriever and aspiration catheters. Net water uptake (NWU) in ischemic zones was evaluated using non-contrasted computed tomography (CT). NWU was calculated using the well-known formula in the symmetrical zone of the brain, in admission and follow-up non-contrasted CT scans, 24 h after EVT.
RESULTS: Fifty-seven patients had successful arterial recanalization (Thrombolysis in Cerebral Infarction scale [TICI] 2b-3), while 36 patients had persistent or recurrent acute LVO (TICI 0-2a). The NWU median at admission was 3.4% in patients with successful EVT and 5.1% in patients with unsuccessful EVT (p < 0.05). The follow-up NWU median was 7.2% after successful EVT and 12.8% in patients with persistent/recurrent acute LVO (p < 0.001).
CONCLUSION: Successful arterial recanalization at AIS due to LVO (TICI 2b -3) led to a significant reduction in brain edema progression in cerebral ischemic foci.