Related Experiment Video
Updated: Feb 12, 2026
In Vivo Tracking of Edema Development and Microvascular Pathology in a Model of Experimental Cerebral Malaria Using Magnetic Resonance Imaging
Published on: June 8, 2017
Association between microvascular cerebral circulation time, malignant brain edema and outcome after successful
Yapeng Guo1, Jia Fang2, Yuepei Gao1
1Department of Neurology, Yijishan Hospital, Wannan Medical College, Wuhu, China.
Background:
Prolonged microvascular cerebral circulation time (mCCT) after endovascular thrombectomy (EVT) may reflect microvascular cerebral circulation impairment. The associations among mCCT, the development of malignant brain edema (MBE), and the functional outcome after successful recanalization (mTICI ≥ 2b) in large vessel occlusion stroke (LVOS) remain unclear.
Material And Methods:
We performed a retrospective analysis of 358 consecutive anterior circulation LVOS patients who achieved successful EVT. mCCT was measured intraprocedurally on DSA using syngo iFlow (Siemens Healthineers). MBE was assessed on follow-up imaging within 72 h. Functional outcome was modified Rankin Scale (mRS) score ≤ 2 at 90 days. Associations were tested using logistic regression and mediation analysis.
Results:
MBE occurred in 42 patients (11.7%). Patients with MBE had significantly prolonged mCCT (median 4.7 s, IQR: 3.6-5.4) vs those without (3.4 s, IQR: 2.8-4.2; p < 0.001). Prolonged mCCT independently predicted MBE (aOR = 2.703; 95% CI: 1.833-3.985; p < 0.001) and unfavorable outcome (mRS > 2; aOR = 3.450; 95% CI: 2.402-4.954; p < 0.001). Adding mCCT to a model (collateral status, admission NIHSS, ASPECTS) significantly improved MBE prediction discrimination (AUC 0.915 vs 0.868; p = 0.015). Mediation analysis showed MBE did not significantly mediate the mCCT-functional outcome relationship (indirect effect coefficient = 0.001, p = 0.200; proportion mediated 7.6%).
Conclusions:
Prolonged mCCT is a potential predictor of both MBE and unfavorable functional outcome after successful EVT for LVOS. While associated with increased MBE risk, mCCT's impact on prognosis appears largely independent of MBE. mCCT is a valuable intraprocedural biomarker for prognostication and guiding early post-EVT management.
Key Points:
Question How does prolonged mCCT after a successful EVT relate to MBE and functional outcomes? Findings Prolonged mCCT is a potential predictor of MBE and unfavorable functional outcomes. MBE does not significantly mediate mCCT's effect on outcomes. Clinical relevance Intraprocedural mCCT measurement identifies high-risk patients for early intervention (e.g., intensive monitoring, osmotherapy). It directly reflects microvascular injury, offering a novel biomarker for individualized post-EVT management.
More Related Videos
04:32Measuring Post-Stroke Cerebral Edema, Infarct Zone and Blood-Brain Barrier Breakdown in a Single Set of Rodent Brain Samples
Published on: October 23, 2020
08:44Continuous IV Infusion is the Choice Treatment Route for Arginine-vasopressin Receptor Blocker Conivaptan in Mice to Study Stroke-evoked Brain Edema
Published on: September 1, 2016
Related Concept Videos
02:17Ecological Succession
02:24Predicting Reaction Outcomes
01:13Outcomes of Glycolysis
Cellular respiration can occur aerobically (with oxygen) or anaerobically (without oxygen). In the presence of oxygen, cellular respiration starts with glycolysis and continues with pyruvate...
01:27Associative Learning
Classical conditioning, also known...
01:21Association Areas of the Cortex
Prefrontal Association Area: This area is located in the frontal lobe and is involved in planning, decision-making, and moderating social behavior. It connects with primary motor areas,...
01:21Coronary Circulation
Coronary circulation begins at the base of the aorta, where two main arteries arise—the left and right coronary arteries. These arteries encircle the heart in the coronary sulcus and supply the...