Ischemic lesion water homeostasis after thrombectomy for large vessel occlusion stroke within the anterior circulation: The impact of age |
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Authors: | Lukas Meyer,Michael Schö nfeld,Matthias Bechstein,Uta Hanning,Bastian Cheng,Gö tz Thomalla,Gerhard Schö n,Andre Kemmling,Jens Fiehler,Gabriel Broocks |
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Affiliation: | 1.Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany;2.Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany;3.Institute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany;4.Department of Neuroradiology, Westpfalz-Klinikum, Kaiserslautern, Germany;5.Faculty of Medicine Mannheim, University of Heidelberg, Heidelberg, Germany |
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Abstract: | The effect of age on lesion pathophysiology in the context of thrombectomy has been poorly investigated. We aimed to investigate the impact of age on ischemic lesion water homeostasis measured with net water uptake (NWU) within a multicenter cohort of patients receiving thrombectomy for anterior circulation large vessel occlusion (LVO) stroke. Lesion-NWU was quantified in multimodal CT on admission and 24 h for calculating Δ-NWU as their difference. The impact of age and procedural parameters on Δ-NWU was analyzed. Multivariable regression analysis was performed to identify significant predictors for Δ-NWU. Two hundred and four patients with anterior circulation stroke were included in the retrospective analysis. Comparison of younger and elderly patients showed no significant differences in NWU on admission but significantly higher Δ-NWU (p = 0.005) on follow-up CT in younger patients. In multivariable regression analysis, higher age was independently associated with lowered Δ-NWU (95% confidence interval: −0.59 to −0.16, p < 0.001). Although successful recanalization (TICI ≥ 2b) significantly reduced Δ-NWU progression by 6.4% (p < 0.001), younger age was still independently associated with higher Δ-NWU (p < 0.001). Younger age is significantly associated with increased brain edema formation after thrombectomy for LVO stroke. Younger patients might be particularly receptive targets for future adjuvant neuroprotective drugs that influence ischemic edema formation. |
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Keywords: | Stroke aging brain ischemia brain edema interventional neuroradiology biomarkers |
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