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2000
Volume 22, Issue 1
  • ISSN: 1567-2026
  • E-ISSN: 1875-5739

Abstract

Introduction

As the fifth vital sign, peripheral oxygen saturation (SpO) remains understudied in acute ischemic stroke (AIS) patients undergoing mechanical thrombectomy (MT). This study aimed to investigate the association between perioperative SpO levels and malignant brain edema (MBE) development in MT-treated AIS patients.

Methods

We retrospectively analyzed consecutive stroke patients who achieved successful recanalization through MT between May 2017 and February 2023. Noninvasive SpO measurements were obtained pre- and postoperatively. Regression analysis was carried out to assess the association between preoperative, postoperative, and combined SpO (stratified into four groups based on SpO median values: HL, high preoperative/low postoperative; LL, low/low; HH, high/high; and LH, low/high) and MBE. DeLong's test was conducted to compare the predictive value of combined SpO with that of preoperative or postoperative SpO alone.

Results

Among 376 patients, 84 (22.34%) patients developed MBE. Although preoperative SpO was not independently associated with MBE (OR: 0.88; 95% CI: 0.78-1.00; =0.0583), postoperative SpO was independently correlated with MBE (OR: 1.48; 95% CI: 1.01-2.18; =0.0440). The LH group demonstrated 5.33-fold higher MBE risk HL (95% CI: 1.80-15.82; =0.0043). Combined SpO assessment outperformed preoperative measurements alone (0.6316 . 0.5478, =0.0382) and trended towards superiority over postoperative values (0.6316 . 0.6022, =0.0541).

Discussion

Preoperative and postoperative SpO exhibit divergent impacts on MBE, likely reflecting distinct pathophysiology. Preoperative hypoxia may exacerbate ischemic core expansion, while postoperative hyperoxia could augment reperfusion injury reactive oxygen species. The LH pattern (low pre-/high post-MT SpO) highlights a high-risk phenotype for MBE.

Conclusion

Preoperative and postoperative SpO differentially influence MBE development, suggesting distinct pathophysiological mechanisms during thrombectomy phases.

© 2025 Bentham Science Publishers
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2025-06-04
2025-09-10

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Relationship between Preoperative and Postoperative Peripheral Oxygen Saturation and Malignant Brain Edema in Stroke Patients Undergoing Mechanical Thrombectomy
Curr Neurovasc Res 22, 53 (2025); https://doi.org/10.2174/0115672026376290250530071306
/content/journals/cnr/10.2174/0115672026376290250530071306
/content/journals/cnr/10.2174/0115672026376290250530071306
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  • Article Type:     Research Article
Keyword(s): malignant brain edema; mechanical thrombectomy; peripheral oxygen saturation; preoperative and postoperative monitoring; pulse oximeter; risk prediction; Stroke

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