Analysis of influencing factors of reversible ischemic edema on cranial CT after mechanical thrombectomy for anterior circulation acute large vessel occlusive stroke
10.3969/j.issn.1673-9701.2025.16.009
- VernacularTitle:前循环急性大血管闭塞性脑卒中机械取栓术后颅脑CT可逆性缺血性水肿的影响因素分析
- Author:
Dongsheng ZHU
1
;
Yang GAO
1
;
Baoxiang WANG
1
;
Junjie XU
1
;
Jin HU
1
Author Information
1. 嘉兴市第一医院神经内科,浙江嘉兴 314000
- Publication Type:Journal Article
- Keywords:
Stroke;
Mechanical thrombectomy;
Cranial CT;
Reversible;
Ischemic edema
- From:
China Modern Doctor
2025;63(16):35-38
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the influencing factors of reversible ischemic edema on cranial CT after mechanical thrombectomy for anterior circulation acute large vessel occlusive stroke(ALVOS).Methods A total of 142 patients with anterior circulation ALVOS who underwent mechanical thrombectomy in the First Hospital of Jiaxing from June 2022 to July 2024 were selected as research subjects.According to the results of the postoperative cranial CT scan after mechanical thrombectomy,they were divided into irreversible ischemic edema group(120 cases)and reversible ischemic edema group(22 cases).The baseline clinical data of the patients were collected.Multivariate Logistic regression analysis was used to identify the influencing factors for reversible ischemic edema on cranial CT after mechanical thrombectomy in patients with anterior circulation ALVOS.Receiver operating characteristic(ROC)curve was constructed to evaluate its predictive value for reversible ischemic edema.Results The results of multivariate Logistic regression analysis showed that age(OR=1.057,95％CI:1.018-1.102,P=0.005)and collateral circulation grade(OR=0.395,95％CI:0.186-0.769,P=0.010)were influencing factors for reversible ischemic edema on cranial CT after mechanical thrombectomy for anterior circulation ALVOS.ROC curve analysis results showed that age,collateral circulation grade and their combination had a certain predictive value for reversible ischemic edema on cranial CT after mechanical thrombectomy for anterior circulation ALVOS.The area under the curve(AUC)of age and collateral circulation grade was 0.664 and 0.715,respectively,and AUC of the combination was 0.785,the best cut-off value was 0.861,the sensitivity was 68.3％,and the specificity was 81.8％.Conclusion The low-density area in the ischemic region on cranial CT after mechanical thrombectomy for a small percentage of anterior circulation ALVOS may be reversible.Younger age and good collateral circulation compensation in patients undergoing mechanical thrombectomy are associated with reversible ischemic edema in postoperative cranial CT.
