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The presence of cerebral reperfusion injury in humans remains controversial
.
Therefore, this review aimed to investigate whether there is reperfusion injury in patients with acute ischaemic stroke in the setting of recanalization after mechanical thrombectomy, and to analyse its effect
on neurological outcomes.
Professor Lou Min's team from the Second Affiliated Hospital of Zhejiang University reviewed the database CIPPIS collected prospectively and included patients who were recanalized after mechanical embolectomy for anterior circulation aortic occlusion, CTP at admission and immediately after recanalization to determine the reperfusion area, and CT and/or magnetic resonance imaging (MRI) immediately after recanalization and 24 hours to determine the lesion area
.
Lesion enlargement in the reperfusion area within 24 hours of recanalization may be caused by reperfusion and is therefore referred to as radiologically observed reperfusion injury (RORI).
According to the imaging method after recanalization, RORI is divided into RORICT and RORIMRI
.
Subsequently, a small cohort of CT and MRI was included immediately after recanalization to verify the consistency of RORICT and RORIMRI (Study 1).
The association of ROLIC with adverse outcomes was then explored in a larger cohort with a modified Rankin scale score of 3 to 6 at 3 months (Study 2).
The results showed that Study 1 included 23 patients and found good agreement between ORIC and RORIMRI (intraclass correlation = 0.
97, P< 0.
001).
Of the 226 patients included in Study 2, a total of 106 (46.
9%) were identified as having RORI
.
The ratio of RORI to reperfusion region was 30.
1 (16.
2 to 51.
0%), independently associated with adverse outcomes (OR = 1.
55/10% [95% CI '1.
30 to 1.
84]; P<0.
001).
The findings suggest that RORI is relatively frequent in stroke patients who recanalize after mechanical thrombectomy, and although recanalization is successful, it is associated with
a poor prognosis.
References:
Reperfusion Injury Is Associated With Poor Outcome in Patients With Recanalization After Thrombectomy.
https://doi.
org/10.
1161/STROKEAHA.
122.
039337Stroke.
2022;0
