Clinical study of mild hypothermia therapy after endovascular mechanical thrombectomy for acute anterior circulation massive cerebral infarction
Objective To explore the efficacy and safety of mild hypothermia therapy in patients with acute anterior circulation massive cerebral infarction after endovascular mechanical thrombectomy. Methods Eighty ⁃ two patients with acute anterior circulation massive cerebral infarction admitted to He'n...
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Tianjin Huanhu Hospital
2025-04-01
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| Series: | Chinese Journal of Contemporary Neurology and Neurosurgery |
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| Online Access: | http://www.cjcnn.org/index.php/cjcnn/article/view/3018 |
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| author | ZHANG Jia⁃qi LIU Yang SHI Yi REN Zhi⁃qiang HAN Bing⁃sha FENG Guang |
| author_facet | ZHANG Jia⁃qi LIU Yang SHI Yi REN Zhi⁃qiang HAN Bing⁃sha FENG Guang |
| author_sort | ZHANG Jia⁃qi |
| collection | DOAJ |
| description | Objective To explore the efficacy and safety of mild hypothermia therapy in patients with acute anterior circulation massive cerebral infarction after endovascular mechanical thrombectomy. Methods Eighty ⁃ two patients with acute anterior circulation massive cerebral infarction admitted to He'nan Provincial People's Hospital from January 2023 to August 2024, who underwent mechanical thrombectomy, were included. Hypothermia group (n = 41) received mild hypothermia therapy with a target core temperature of 33-34 ℃ for 48-72 h immediately after surgery, and the others didn't (mechanical thrombectomy group, n = 41). Serum neuron⁃specific enolase (NSE) levels were measured 72 h after operation; prognosis was assessed using the modified Rankin Scale (mRS) at 3 months after discharge, and good prognosis and morbidity and mortality rates were recorded; as well as the complication rates were recorded during hospitalization after surgery. Univariate and multivariate Logistic regression analyses were used to screen for factors influencing prognosis after mechanical thrombectomy in patients with acute anterior circulation massive cerebral infarction. Results The serum NSE level at 72 h after operation in the hypothermia group was lower than the mechanical thrombectomy group [18.86 (13.35, 30.54) μg/L vs. 21.43 (18.30, 32.90) μg/L; Z = ⁃ 2.147, P = 0.032], and the good prognosis rate at 3 months after discharge was higher than the mechanical thrombectomy group [46.34% (19/41) vs. 21.95% (9/41); χ2 = 5.423, P = 0.020], and the mortality rate (χ2 = 0.734, P = 0.391), incidence of hemorrhagic transformation (χ2 = 0.497, P = 0.481), vascular reocclusion (χ2 = 0.945, P = 0.331), malignant brain edema (χ2 = 1.058, P = 0.304), pulmonary infection (χ2 = 2.614, P = 0.106), electrolyte disturbance (χ2 = 1.222, P = 0.269), arrhythmia (χ2 = 0.456, P = 0.499), deep venous thrombosis (χ2 = 0.311, P = 0.577), and abnormal coagulation function (χ2 = 1.246, P = 0.264) during hospitalization between the 2 groups were not statistically significant. Logistic regression analysis showed that mild hypothermia was a protective factor for good prognosis after mechanical thrombectomy for acute anterior circulation massive cerebral infarction (OR = 4.457, 95%CI: 1.503-13.759; P = 0.007), while age increase (OR = 0.915, 95%CI: 0.856-0.978; P = 0.009), history of hypertension (OR = 0.175, 95%CI: 0.055-0.562; P = 0.003) were risk factors for poor prognosis. Conclusions Mild hypothermia after mechanical thrombectomy in patients with acute anterior circulation massive cerebral infarction is safe and feasible. Reducing NSE release may be one of its action pathways, and large⁃scale randomized controlled trials are needed to further verify its efficacy. |
| format | Article |
| id | doaj-art-f3664e01cf904f34bb8196e2a84a82a5 |
| institution | Kabale University |
| issn | 1672-6731 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Tianjin Huanhu Hospital |
| record_format | Article |
| series | Chinese Journal of Contemporary Neurology and Neurosurgery |
| spelling | doaj-art-f3664e01cf904f34bb8196e2a84a82a52025-08-20T03:48:06ZengTianjin Huanhu HospitalChinese Journal of Contemporary Neurology and Neurosurgery1672-67312025-04-0125432333110.3969/j.issn.1672⁃6731.2025.04.010Clinical study of mild hypothermia therapy after endovascular mechanical thrombectomy for acute anterior circulation massive cerebral infarctionZHANG Jia⁃qi0LIU Yang1SHI Yi2REN Zhi⁃qiang3HAN Bing⁃sha4FENG Guang5Department of Neurosurgery Intensive Care Unit, He'nan University People's Hospital; He'nan Provincial People's Hospital, Zhengzhou 450003, He'nan, ChinaDepartment of Neurosurgery Intensive Care Unit, He'nan University People's Hospital; He'nan Provincial People's Hospital, Zhengzhou 450003, He'nan, ChinaDepartment of Neurosurgery Intensive Care Unit, He'nan University People's Hospital; He'nan Provincial People's Hospital, Zhengzhou 450003, He'nan, ChinaDepartment of Neurosurgery Intensive Care Unit, He'nan University People's Hospital; He'nan Provincial People's Hospital, Zhengzhou 450003, He'nan, ChinaDepartment of Neurosurgery Intensive Care Unit, He'nan University People's Hospital; He'nan Provincial People's Hospital, Zhengzhou 450003, He'nan, ChinaDepartment of Neurosurgery Intensive Care Unit, He'nan University People's Hospital; He'nan Provincial People's Hospital, Zhengzhou 450003, He'nan, ChinaObjective To explore the efficacy and safety of mild hypothermia therapy in patients with acute anterior circulation massive cerebral infarction after endovascular mechanical thrombectomy. Methods Eighty ⁃ two patients with acute anterior circulation massive cerebral infarction admitted to He'nan Provincial People's Hospital from January 2023 to August 2024, who underwent mechanical thrombectomy, were included. Hypothermia group (n = 41) received mild hypothermia therapy with a target core temperature of 33-34 ℃ for 48-72 h immediately after surgery, and the others didn't (mechanical thrombectomy group, n = 41). Serum neuron⁃specific enolase (NSE) levels were measured 72 h after operation; prognosis was assessed using the modified Rankin Scale (mRS) at 3 months after discharge, and good prognosis and morbidity and mortality rates were recorded; as well as the complication rates were recorded during hospitalization after surgery. Univariate and multivariate Logistic regression analyses were used to screen for factors influencing prognosis after mechanical thrombectomy in patients with acute anterior circulation massive cerebral infarction. Results The serum NSE level at 72 h after operation in the hypothermia group was lower than the mechanical thrombectomy group [18.86 (13.35, 30.54) μg/L vs. 21.43 (18.30, 32.90) μg/L; Z = ⁃ 2.147, P = 0.032], and the good prognosis rate at 3 months after discharge was higher than the mechanical thrombectomy group [46.34% (19/41) vs. 21.95% (9/41); χ2 = 5.423, P = 0.020], and the mortality rate (χ2 = 0.734, P = 0.391), incidence of hemorrhagic transformation (χ2 = 0.497, P = 0.481), vascular reocclusion (χ2 = 0.945, P = 0.331), malignant brain edema (χ2 = 1.058, P = 0.304), pulmonary infection (χ2 = 2.614, P = 0.106), electrolyte disturbance (χ2 = 1.222, P = 0.269), arrhythmia (χ2 = 0.456, P = 0.499), deep venous thrombosis (χ2 = 0.311, P = 0.577), and abnormal coagulation function (χ2 = 1.246, P = 0.264) during hospitalization between the 2 groups were not statistically significant. Logistic regression analysis showed that mild hypothermia was a protective factor for good prognosis after mechanical thrombectomy for acute anterior circulation massive cerebral infarction (OR = 4.457, 95%CI: 1.503-13.759; P = 0.007), while age increase (OR = 0.915, 95%CI: 0.856-0.978; P = 0.009), history of hypertension (OR = 0.175, 95%CI: 0.055-0.562; P = 0.003) were risk factors for poor prognosis. Conclusions Mild hypothermia after mechanical thrombectomy in patients with acute anterior circulation massive cerebral infarction is safe and feasible. Reducing NSE release may be one of its action pathways, and large⁃scale randomized controlled trials are needed to further verify its efficacy.http://www.cjcnn.org/index.php/cjcnn/article/view/3018ischemic strokethrombectomyhypothermia， inducedneuroprotectionprognosisrisk factorslogistic models |
| spellingShingle | ZHANG Jia⁃qi LIU Yang SHI Yi REN Zhi⁃qiang HAN Bing⁃sha FENG Guang Clinical study of mild hypothermia therapy after endovascular mechanical thrombectomy for acute anterior circulation massive cerebral infarction Chinese Journal of Contemporary Neurology and Neurosurgery ischemic stroke thrombectomy hypothermia， induced neuroprotection prognosis risk factors logistic models |
| title | Clinical study of mild hypothermia therapy after endovascular mechanical thrombectomy for acute anterior circulation massive cerebral infarction |
| title_full | Clinical study of mild hypothermia therapy after endovascular mechanical thrombectomy for acute anterior circulation massive cerebral infarction |
| title_fullStr | Clinical study of mild hypothermia therapy after endovascular mechanical thrombectomy for acute anterior circulation massive cerebral infarction |
| title_full_unstemmed | Clinical study of mild hypothermia therapy after endovascular mechanical thrombectomy for acute anterior circulation massive cerebral infarction |
| title_short | Clinical study of mild hypothermia therapy after endovascular mechanical thrombectomy for acute anterior circulation massive cerebral infarction |
| title_sort | clinical study of mild hypothermia therapy after endovascular mechanical thrombectomy for acute anterior circulation massive cerebral infarction |
| topic | ischemic stroke thrombectomy hypothermia， induced neuroprotection prognosis risk factors logistic models |
| url | http://www.cjcnn.org/index.php/cjcnn/article/view/3018 |
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