ArticleFrontiers in neurology
Contrast extravasation on Dyna-CT as a predictor of malignant brain edema after mechanical thrombectomy for acute anterior circulation large vessel occlusion.
Article in Frontiers in neurology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Contrast agent extravasation detected on immediate post-thrombectomy flat-panel detector computed tomography (Dyna-CT) may reflect blood-brain barrier disruption and microcirculatory dysfunction following mechanical thrombectomy (MT) for acute anterior circulation large vessel occlusion (AC-LVO). This study aimed to determine whether contrast extravasation on Dyna-CT after successful MT is associated with the subsequent development of malignant brain edema (MBE). Methods: A retrospective study was conducted in AC-LVO patients who underwent MT with successful recanalization between January 2020 and December 2023. Dyna-CT was performed immediately after MT, followed by serial head CT scans. MBE was defined as acute cerebral swelling with a midline shift ≥5 mm accompanied by radiological signs of brain herniation. Patients were divided into MBE and non-MBE groups. Multivariable logistic regression analyses were performed to identify independent predictors of MBE and construct a predictive model. Results: A total of 174 patients (median age, 71 years) were included, with an MBE incidence of 23.6% (41/174). Core infarct volume, baseline NIHSS score, collateral circulation, number of thrombectomy passes, and contrast extravasation were independent predictors of MBE (all Conclusion: Immediate Dyna-CT detection of contrast extravasation serves as a valuable imaging biomarker for predicting MBE in AC-LVO patients after successful MT, offering timely guidance for early risk identification and individualized management.
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