Application of noninvasive dynamic brain edema monitoring in patients with acute anterior circulation large vessel occlusion undergoing interventional therapy
ZHU Jinzhao
ZHANG Jiangang
YANG Xinli
WU Kun
FENG Guang
Abstract：Objective To explore the clinical application value of noninvasive dynamic brain edema monitoring tech-nology in patients with acute anterior circulation large vessel occlusion undergoing interventional therapy.Methods From March 2022 to March 2023,60 patients with acute anterior circulation large vessel occlusion were prospectively enrolled and randomly divided into an observation group(n=30)and a control group(n=30)using a random number table.After interventional therapy,the observation group received treatment guided by noninvasive dynamic brain edema monitoring,while the control group re-ceived conventional empirical treatment.Results Compared with the control group,the observation group showed a significant-ly higher rate of favorable prognosis(modified Rankin Scale score 0～2)at 3 months after discharge(40.0%vs.26.7%,P=0.035),a significantly lower mean daily dosage of mannitol[(292.5±94.6)mL vs.(352.6±112.4)mL,P=0.029],a significantly shorter duration of mannitol use[(12.1±5.2)days vs.(15.2±6.1)days,P=0.038],and a significantly lower incidence of renal impairment(6.7%vs.26.7%,P=0.038).The noninvasive dynamic brain edema monitoring results indicated that in the observation group,the electromagnetic disturbance coefficient peaked at 3 days after onset and then gradually declined.After mannitol treatment,the electromagnetic disturbance coefficient decreased significantly,with the most pronounced decrease at 1 hour post-treatment,grad-ually stabilizing by 3 hours post-treatment.Among the 30 patients in the observation group,17(56.7%)underwent decompressive craniectomy after interventional therapy,while 13(43.3%)did not.Compared to patients who did not undergo decompressive craniectomy,those who did showed a significantly lower electromagnetic disturbance coefficient[(116.3±8.7)vs.(127.1±14.1),P=0.016].ROC curve analysis revealed that the electromagnetic disturbance coefficient had certain predictive value for the need of decompressive craniectomy after interventional therapy in patients with acute anterior circulation large vessel occlusion.The area under the curve was 0.756(95%CI 0.565-0.893,P=0.005),with an optimal cut-off value of 112.5.The sensitivity,specificity,and Youden index were 52.9%,92.3%,and 0.453,respectively.Conclusion For patients with acute intracranial anterior circula-tion large vessel occlusion undergoing interventional therapy,noninvasive dynamic brain edema monitoring technology can guide the use of mannitol,reduce complications,and improve patient prognosis.
Keywords：acute ischemic strokeanterior circulation large vessel occlusioninterventional therapynoninvasive dy-namic brain edema monitoring
Publication Date：2025-10-25
Online Publishing Date：2026-01-07(First online date of this platform, not the publication date of the document)
Pages：5( 596-600 )