Neuroimaging predictors of malignant brain oedema after thrombectomy in ischemic stroke: a systematic review and meta-analysis
Background We systematically reviewed neuroimaging predictors for malignant brain oedema (MBE) after thrombectomy in patients with ischemic stroke.Methods We searched MEDLINE and EMBASE in November 2023 for studies of patients with ischemic stroke. We included studies investigating neuroimaging pred...
Saved in:
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Taylor & Francis Group
2025-12-01
|
| Series: | Annals of Medicine |
| Subjects: | |
| Online Access: | https://www.tandfonline.com/doi/10.1080/07853890.2025.2453635 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832592412489285632 |
|---|---|
| author | Linrui Huang Xindi Song Jingjing Li Yanan Wang Xing Hua Meng Liu Ming Liu Simiao Wu |
| author_facet | Linrui Huang Xindi Song Jingjing Li Yanan Wang Xing Hua Meng Liu Ming Liu Simiao Wu |
| author_sort | Linrui Huang |
| collection | DOAJ |
| description | Background We systematically reviewed neuroimaging predictors for malignant brain oedema (MBE) after thrombectomy in patients with ischemic stroke.Methods We searched MEDLINE and EMBASE in November 2023 for studies of patients with ischemic stroke. We included studies investigating neuroimaging predictors or prediction models for MBE after thrombectomy. We estimated effect size for the association between predictors and MBE by odds ratios (ORs) or standardized mean differences (SMDs), and pooled results using random-effects modelling.Results We included 19 studies (n = 6007) with 17 neuroimaging factors and 5 models. Lower Alberta Stroke Program Early CT scores (ASPECTS, n = 3052, SMD −1.84, 95% CI −2.52 – −1.16; df = 9) and longer extent of arterial occlusion at baseline were associated with higher risk of MBE. Post-thrombectomy ASPECTS was associated with MBE in general stroke patients (n = 453, SMD −2.91, −4.02 – −1.79; df = 1), but not in successfully reperfused patients (n = 110, SMD 0.24, −0.16 – 0.65). Successful reperfusion reduced risk of MBE (n = 4851, OR 0.39, 0.30–0.51; df = 13). Contrast enhancement on CT after thrombectomy was associated with higher risk of MBE (n = 998, OR 4.82, 2.53–9.20; df = 4). More reserved brain volume capacity (baseline: n = 683, OR 0.83, 0.77–0.91, p < .001; post-thrombectomy: n = 329, OR 0.53, 0.37–0.77, p < .001) and good collaterals (baseline: n = 2301, OR 0.14, 0.10–0.20, df = 3; post-thrombectomy: n = 1006, OR 0.28, 0.15–0.51; df = 2) were associated with lower risk of MBE.Conclusion Lower ASPECTS and longer arterial occlusion at baseline, and post-thrombectomy CT contrast enhancement increased risk of MBE. Reperfusion after thrombectomy, more reserved brain volume and good collaterals at baseline and post-thrombectomy reduced its risk. |
| format | Article |
| id | doaj-art-5e79e923dd2b459fb388a35bc81c86cc |
| institution | Kabale University |
| issn | 0785-3890 1365-2060 |
| language | English |
| publishDate | 2025-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Annals of Medicine |
| spelling | doaj-art-5e79e923dd2b459fb388a35bc81c86cc2025-01-21T08:34:23ZengTaylor & Francis GroupAnnals of Medicine0785-38901365-20602025-12-0157110.1080/07853890.2025.2453635Neuroimaging predictors of malignant brain oedema after thrombectomy in ischemic stroke: a systematic review and meta-analysisLinrui Huang0Xindi Song1Jingjing Li2Yanan Wang3Xing Hua4Meng Liu5Ming Liu6Simiao Wu7Department of Neurology, West China Hospital, Sichuan University, Chengdu, ChinaDepartment of Neurology, West China Hospital, Sichuan University, Chengdu, ChinaDepartment of Neurology, West China Hospital, Sichuan University, Chengdu, ChinaDepartment of Neurology, West China Hospital, Sichuan University, Chengdu, ChinaDepartment of Neurology, West China Hospital, Sichuan University, Chengdu, ChinaDepartment of Neurology, West China Hospital, Sichuan University, Chengdu, ChinaDepartment of Neurology, West China Hospital, Sichuan University, Chengdu, ChinaDepartment of Neurology, West China Hospital, Sichuan University, Chengdu, ChinaBackground We systematically reviewed neuroimaging predictors for malignant brain oedema (MBE) after thrombectomy in patients with ischemic stroke.Methods We searched MEDLINE and EMBASE in November 2023 for studies of patients with ischemic stroke. We included studies investigating neuroimaging predictors or prediction models for MBE after thrombectomy. We estimated effect size for the association between predictors and MBE by odds ratios (ORs) or standardized mean differences (SMDs), and pooled results using random-effects modelling.Results We included 19 studies (n = 6007) with 17 neuroimaging factors and 5 models. Lower Alberta Stroke Program Early CT scores (ASPECTS, n = 3052, SMD −1.84, 95% CI −2.52 – −1.16; df = 9) and longer extent of arterial occlusion at baseline were associated with higher risk of MBE. Post-thrombectomy ASPECTS was associated with MBE in general stroke patients (n = 453, SMD −2.91, −4.02 – −1.79; df = 1), but not in successfully reperfused patients (n = 110, SMD 0.24, −0.16 – 0.65). Successful reperfusion reduced risk of MBE (n = 4851, OR 0.39, 0.30–0.51; df = 13). Contrast enhancement on CT after thrombectomy was associated with higher risk of MBE (n = 998, OR 4.82, 2.53–9.20; df = 4). More reserved brain volume capacity (baseline: n = 683, OR 0.83, 0.77–0.91, p < .001; post-thrombectomy: n = 329, OR 0.53, 0.37–0.77, p < .001) and good collaterals (baseline: n = 2301, OR 0.14, 0.10–0.20, df = 3; post-thrombectomy: n = 1006, OR 0.28, 0.15–0.51; df = 2) were associated with lower risk of MBE.Conclusion Lower ASPECTS and longer arterial occlusion at baseline, and post-thrombectomy CT contrast enhancement increased risk of MBE. Reperfusion after thrombectomy, more reserved brain volume and good collaterals at baseline and post-thrombectomy reduced its risk.https://www.tandfonline.com/doi/10.1080/07853890.2025.2453635Brain oedemaischemic strokethrombectomyneuroimagingsystematic review |
| spellingShingle | Linrui Huang Xindi Song Jingjing Li Yanan Wang Xing Hua Meng Liu Ming Liu Simiao Wu Neuroimaging predictors of malignant brain oedema after thrombectomy in ischemic stroke: a systematic review and meta-analysis Annals of Medicine Brain oedema ischemic stroke thrombectomy neuroimaging systematic review |
| title | Neuroimaging predictors of malignant brain oedema after thrombectomy in ischemic stroke: a systematic review and meta-analysis |
| title_full | Neuroimaging predictors of malignant brain oedema after thrombectomy in ischemic stroke: a systematic review and meta-analysis |
| title_fullStr | Neuroimaging predictors of malignant brain oedema after thrombectomy in ischemic stroke: a systematic review and meta-analysis |
| title_full_unstemmed | Neuroimaging predictors of malignant brain oedema after thrombectomy in ischemic stroke: a systematic review and meta-analysis |
| title_short | Neuroimaging predictors of malignant brain oedema after thrombectomy in ischemic stroke: a systematic review and meta-analysis |
| title_sort | neuroimaging predictors of malignant brain oedema after thrombectomy in ischemic stroke a systematic review and meta analysis |
| topic | Brain oedema ischemic stroke thrombectomy neuroimaging systematic review |
| url | https://www.tandfonline.com/doi/10.1080/07853890.2025.2453635 |
| work_keys_str_mv | AT linruihuang neuroimagingpredictorsofmalignantbrainoedemaafterthrombectomyinischemicstrokeasystematicreviewandmetaanalysis AT xindisong neuroimagingpredictorsofmalignantbrainoedemaafterthrombectomyinischemicstrokeasystematicreviewandmetaanalysis AT jingjingli neuroimagingpredictorsofmalignantbrainoedemaafterthrombectomyinischemicstrokeasystematicreviewandmetaanalysis AT yananwang neuroimagingpredictorsofmalignantbrainoedemaafterthrombectomyinischemicstrokeasystematicreviewandmetaanalysis AT xinghua neuroimagingpredictorsofmalignantbrainoedemaafterthrombectomyinischemicstrokeasystematicreviewandmetaanalysis AT mengliu neuroimagingpredictorsofmalignantbrainoedemaafterthrombectomyinischemicstrokeasystematicreviewandmetaanalysis AT mingliu neuroimagingpredictorsofmalignantbrainoedemaafterthrombectomyinischemicstrokeasystematicreviewandmetaanalysis AT simiaowu neuroimagingpredictorsofmalignantbrainoedemaafterthrombectomyinischemicstrokeasystematicreviewandmetaanalysis |