Neuroprotective Effects of Rapid Local Ischemic Postconditioning in Successful Endovascular Thrombectomy Patients

Jiangshan Deng; Guangchen He; Tingyu Yi; Liming Wei; Haitao Lu; Qing Zhou; Ye Yao; Chengcheng Zhu; Michael R. Levitt; Mahmud Mossa-Basha; Haibo Yang; Yi Shen; Feng Shi; Duolao Wang; Longting Lin; Mark Parsons; Wenhuo Chen; Yueqi Zhu

doi:10.1161/strokeaha.124.047674

Neuroprotective Effects of Rapid Local Ischemic Postconditioning in Successful Endovascular Thrombectomy Patients

Jiangshan Deng, Guangchen He, Tingyu Yi, Liming Wei, Haitao Lu, Qing Zhou, Ye Yao, Chengcheng Zhu, Michael R. Levitt, Mahmud Mossa-Basha, Haibo Yang, Yi Shen, Feng Shi, Duolao Wang, Longting Lin, Mark Parsons, Wenhuo Chen, Yueqi Zhu

Clinical Sciences

Research output: Contribution to journal › Article › peer-review

5 Citations (Scopus)

Abstract

BACKGROUND:

We aim to assess the efficacy of rapid local ischemic postconditioning (RL-IPostC) following successful reperfusion in patients with acute ischemic stroke with anterior circulation large vessel occlusion who underwent endovascular thrombectomy.

METHODS:

We conducted an ambidirectional cohort study with 78 prospectively enrolled patients with RL-IPostC and endovascular thrombectomy and 129 retrospectively enrolled patients with endovascular thrombectomy. The RL-IPostC procedure involved 5 cycles of 15-s balloon inflation and deflation in the ipsilateral internal carotid artery. The primary outcome was functional independence, defined as a modified Rankin Scale score of 0 to 2. Secondary outcomes included excellent outcomes (modified Rankin Scale score, 0–1) and early therapeutic response. Imaging outcomes involved infarct volume changes and cerebral edema measurements. Outcomes were compared with postpropensity score matching (1:1) and assessed using univariable and multivariable regression models.

RESULTS:

In the matched cohort of 136 patients (mean age, 71±14 years; 70 men [51%]), RL-IPostC was associated with a higher rate of functional independence (adjusted odds ratio, 2.47 [95% CI, 1.10–5.68]; P=0.030). The RL-IPostC group exhibited significantly reduced infarct volumes at 24 hours (difference, −12.2 [95% CI, −23.9 to −0.53]; P=0.041) and less infarct growth (difference, −12.2 [95% CI, −23.9 to −0.45]; P=0.042). Furthermore, RL-IPostC correlated with lower increases in net water uptake (difference, −0.04 [95% CI, −0.07 to −0.01]; P=0.018), lower decrease cerebrospinal fluid volume (difference, −7.75 [95% CI, −11.7 to −3.84]; P<0.001), and reduced midline shift at 24 hours (difference, −1.39 [95% CI, −2.48 to −0.30]; P=0.013).

CONCLUSIONS:

RL-IPostC tends to promote functional independence and reduces infarct growth and cerebral edema in patients with acute ischemic stroke post-reperfusion.

Original language	English
Pages (from-to)	2896-2900
Number of pages	5
Journal	Stroke
Volume	55
Issue number	12
Early online date	11 Nov 2024
DOIs	https://doi.org/10.1161/strokeaha.124.047674
Publication status	Published - 11 Nov 2024

Keywords

brain edema
cerebral infarction
ischemic postconditioning
stroke
thrombectomy

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10.1161/strokeaha.124.047674

Stroke-Neuroprotective Effects of Rapid Local Ischemic Postconditioning in Successful Endovascular Thrombectomy PatientsAccepted author manuscript, 1.44 MB

Cite this

Deng, J., He, G., Yi, T., Wei, L., Lu, H., Zhou, Q., Yao, Y., Zhu, C., Levitt, M. R., Mossa-Basha, M., Yang, H., Shen, Y., Shi, F., Wang, D., Lin, L., Parsons, M., Chen, W., & Zhu, Y. (2024). Neuroprotective Effects of Rapid Local Ischemic Postconditioning in Successful Endovascular Thrombectomy Patients. Stroke, 55(12), 2896-2900. https://doi.org/10.1161/strokeaha.124.047674

@article{5384f6fad3b942968dac3d4e9c601823,

title = "Neuroprotective Effects of Rapid Local Ischemic Postconditioning in Successful Endovascular Thrombectomy Patients",

abstract = "BACKGROUND:We aim to assess the efficacy of rapid local ischemic postconditioning (RL-IPostC) following successful reperfusion in patients with acute ischemic stroke with anterior circulation large vessel occlusion who underwent endovascular thrombectomy.METHODS:We conducted an ambidirectional cohort study with 78 prospectively enrolled patients with RL-IPostC and endovascular thrombectomy and 129 retrospectively enrolled patients with endovascular thrombectomy. The RL-IPostC procedure involved 5 cycles of 15-s balloon inflation and deflation in the ipsilateral internal carotid artery. The primary outcome was functional independence, defined as a modified Rankin Scale score of 0 to 2. Secondary outcomes included excellent outcomes (modified Rankin Scale score, 0–1) and early therapeutic response. Imaging outcomes involved infarct volume changes and cerebral edema measurements. Outcomes were compared with postpropensity score matching (1:1) and assessed using univariable and multivariable regression models.RESULTS:In the matched cohort of 136 patients (mean age, 71±14 years; 70 men [51\%]), RL-IPostC was associated with a higher rate of functional independence (adjusted odds ratio, 2.47 [95\% CI, 1.10–5.68]; P=0.030). The RL-IPostC group exhibited significantly reduced infarct volumes at 24 hours (difference, −12.2 [95\% CI, −23.9 to −0.53]; P=0.041) and less infarct growth (difference, −12.2 [95\% CI, −23.9 to −0.45]; P=0.042). Furthermore, RL-IPostC correlated with lower increases in net water uptake (difference, −0.04 [95\% CI, −0.07 to −0.01]; P=0.018), lower decrease cerebrospinal fluid volume (difference, −7.75 [95\% CI, −11.7 to −3.84]; P<0.001), and reduced midline shift at 24 hours (difference, −1.39 [95\% CI, −2.48 to −0.30]; P=0.013).CONCLUSIONS:RL-IPostC tends to promote functional independence and reduces infarct growth and cerebral edema in patients with acute ischemic stroke post-reperfusion.",

keywords = "brain edema, cerebral infarction, ischemic postconditioning, stroke, thrombectomy",

author = "Jiangshan Deng and Guangchen He and Tingyu Yi and Liming Wei and Haitao Lu and Qing Zhou and Ye Yao and Chengcheng Zhu and Levitt, \{Michael R.\} and Mahmud Mossa-Basha and Haibo Yang and Yi Shen and Feng Shi and Duolao Wang and Longting Lin and Mark Parsons and Wenhuo Chen and Yueqi Zhu",

year = "2024",

month = nov,

day = "11",

doi = "10.1161/strokeaha.124.047674",

language = "English",

volume = "55",

pages = "2896--2900",

journal = "Stroke",

issn = "0039-2499",

publisher = "Wolters Kluwer Health",

number = "12",

}

Deng, J, He, G, Yi, T, Wei, L, Lu, H, Zhou, Q, Yao, Y, Zhu, C, Levitt, MR, Mossa-Basha, M, Yang, H, Shen, Y, Shi, F, Wang, D, Lin, L, Parsons, M, Chen, W & Zhu, Y 2024, 'Neuroprotective Effects of Rapid Local Ischemic Postconditioning in Successful Endovascular Thrombectomy Patients', Stroke, vol. 55, no. 12, pp. 2896-2900. https://doi.org/10.1161/strokeaha.124.047674

TY - JOUR

T1 - Neuroprotective Effects of Rapid Local Ischemic Postconditioning in Successful Endovascular Thrombectomy Patients

AU - Deng, Jiangshan

AU - He, Guangchen

AU - Yi, Tingyu

AU - Wei, Liming

AU - Lu, Haitao

AU - Zhou, Qing

AU - Yao, Ye

AU - Zhu, Chengcheng

AU - Levitt, Michael R.

AU - Mossa-Basha, Mahmud

AU - Yang, Haibo

AU - Shen, Yi

AU - Shi, Feng

AU - Wang, Duolao

AU - Lin, Longting

AU - Parsons, Mark

AU - Chen, Wenhuo

AU - Zhu, Yueqi

PY - 2024/11/11

Y1 - 2024/11/11

N2 - BACKGROUND:We aim to assess the efficacy of rapid local ischemic postconditioning (RL-IPostC) following successful reperfusion in patients with acute ischemic stroke with anterior circulation large vessel occlusion who underwent endovascular thrombectomy.METHODS:We conducted an ambidirectional cohort study with 78 prospectively enrolled patients with RL-IPostC and endovascular thrombectomy and 129 retrospectively enrolled patients with endovascular thrombectomy. The RL-IPostC procedure involved 5 cycles of 15-s balloon inflation and deflation in the ipsilateral internal carotid artery. The primary outcome was functional independence, defined as a modified Rankin Scale score of 0 to 2. Secondary outcomes included excellent outcomes (modified Rankin Scale score, 0–1) and early therapeutic response. Imaging outcomes involved infarct volume changes and cerebral edema measurements. Outcomes were compared with postpropensity score matching (1:1) and assessed using univariable and multivariable regression models.RESULTS:In the matched cohort of 136 patients (mean age, 71±14 years; 70 men [51%]), RL-IPostC was associated with a higher rate of functional independence (adjusted odds ratio, 2.47 [95% CI, 1.10–5.68]; P=0.030). The RL-IPostC group exhibited significantly reduced infarct volumes at 24 hours (difference, −12.2 [95% CI, −23.9 to −0.53]; P=0.041) and less infarct growth (difference, −12.2 [95% CI, −23.9 to −0.45]; P=0.042). Furthermore, RL-IPostC correlated with lower increases in net water uptake (difference, −0.04 [95% CI, −0.07 to −0.01]; P=0.018), lower decrease cerebrospinal fluid volume (difference, −7.75 [95% CI, −11.7 to −3.84]; P<0.001), and reduced midline shift at 24 hours (difference, −1.39 [95% CI, −2.48 to −0.30]; P=0.013).CONCLUSIONS:RL-IPostC tends to promote functional independence and reduces infarct growth and cerebral edema in patients with acute ischemic stroke post-reperfusion.

AB - BACKGROUND:We aim to assess the efficacy of rapid local ischemic postconditioning (RL-IPostC) following successful reperfusion in patients with acute ischemic stroke with anterior circulation large vessel occlusion who underwent endovascular thrombectomy.METHODS:We conducted an ambidirectional cohort study with 78 prospectively enrolled patients with RL-IPostC and endovascular thrombectomy and 129 retrospectively enrolled patients with endovascular thrombectomy. The RL-IPostC procedure involved 5 cycles of 15-s balloon inflation and deflation in the ipsilateral internal carotid artery. The primary outcome was functional independence, defined as a modified Rankin Scale score of 0 to 2. Secondary outcomes included excellent outcomes (modified Rankin Scale score, 0–1) and early therapeutic response. Imaging outcomes involved infarct volume changes and cerebral edema measurements. Outcomes were compared with postpropensity score matching (1:1) and assessed using univariable and multivariable regression models.RESULTS:In the matched cohort of 136 patients (mean age, 71±14 years; 70 men [51%]), RL-IPostC was associated with a higher rate of functional independence (adjusted odds ratio, 2.47 [95% CI, 1.10–5.68]; P=0.030). The RL-IPostC group exhibited significantly reduced infarct volumes at 24 hours (difference, −12.2 [95% CI, −23.9 to −0.53]; P=0.041) and less infarct growth (difference, −12.2 [95% CI, −23.9 to −0.45]; P=0.042). Furthermore, RL-IPostC correlated with lower increases in net water uptake (difference, −0.04 [95% CI, −0.07 to −0.01]; P=0.018), lower decrease cerebrospinal fluid volume (difference, −7.75 [95% CI, −11.7 to −3.84]; P<0.001), and reduced midline shift at 24 hours (difference, −1.39 [95% CI, −2.48 to −0.30]; P=0.013).CONCLUSIONS:RL-IPostC tends to promote functional independence and reduces infarct growth and cerebral edema in patients with acute ischemic stroke post-reperfusion.

KW - brain edema

KW - cerebral infarction

KW - ischemic postconditioning

KW - stroke

KW - thrombectomy

U2 - 10.1161/strokeaha.124.047674

DO - 10.1161/strokeaha.124.047674

M3 - Article

SN - 0039-2499

VL - 55

SP - 2896

EP - 2900

JO - Stroke

JF - Stroke

IS - 12

ER -

Neuroprotective Effects of Rapid Local Ischemic Postconditioning in Successful Endovascular Thrombectomy Patients

Abstract

Keywords

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