%0 Journal Article
%T Association between Peripheral Arterial Lactate Levels and Malignant Brain Edema Following Endovascular Treatment for Ischemic Stroke.
%A Wang H
%A Yuan R
%A Shen P
%A Yu X
%A Chen X
%A Shang Y
%A Xu J
%A Tan M
%A Zhang S
%A Geng Y
%J Curr Neurovasc Res
%V 20
%N 5
%D 2024
%M 39004958
%F 2.294
%R 10.2174/0115672026283642231212061910
%X <B>OBJECTIVE: </B>To investigate the factors of postoperative malignant brain edema (MBE) in patients with acute ischemic stroke (AIS) treated with endovascular treatment (EVT).<BR><B>BACKGROUND: </B>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.<BR><B>OBJECTIVE: </B>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.<BR><B>METHODS: </B>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.<BR><B>RESULTS: </B>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).<BR><B>CONCLUSIONS: </B>Early increase in PAL levels is an independent predictor of MBE after EVT in AIS patients.