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Objective <p>This study aimed to evaluate the temporal changes in arterial blood gas (ABG) parameters and their relationship with clinical and radiological outcomes in patients undergoing mechanical thrombectomy due to acute ischemic stroke.</p> Materials and methods <p>A total of 65 patients (mean age: 67.7 ± 14.4 years) who underwent mechanical thrombectomy for anterior circulation large-vessel occlusion at Gaziantep City Hospital were included. Arterial blood gas parameters (pH, SaO₂, PaCO₂, PaO₂, lactate, HCO₃⁻) were recorded before thrombectomy and at the 1st, 3rd, and 5th hours after the procedure. Clinical outcomes were assessed using NIH Stroke Scale (NIHSS) scores, Alberta Stroke Program Early CT Scores (ASPECTS), modified Rankin Scale (mRS) at 3 months, and the presence of hemorrhagic transformation according to ECASS-II criteria.</p> Results <p>No significant correlation was found between serial ABG parameters and 3-month functional outcome (mRS). In robust regression analysis, higher pre-procedural pH was significantly associated with higher post-procedural ASPECTS (β = 0.737, <i>p</i> = 0.017), whereas elevated pre-procedural lactate levels were significantly associated with lower post- procedural ASPECTS (β = − 2.326, <i>p</i> &lt; 0.001). In multivariable logistic regression, only baseline NIHSS (OR = 1.21, 95% CI: 1.01–1.44, <i>p</i> = 0.035) and hemorrhagic transformation (OR = 13.94, 95% CI: 2.16–90.18, <i>p</i> = 0.006) were independently associated with poor functional outcome (3-month mRS ≥ 3); ABG parameters did not retain independent predictive value.</p> Conclusion <p>Although certain pre-thrombectomy ABG parameters, particularly pH and lactate, were associated with neuroimaging markers of tissue integrity, arterial blood gas measurements did not independently predict long-term functional outcome. Initial neurological severity and hemorrhagic transformation remained the key determinants of prognosis. ABG monitoring may therefore be considered an adjunctive physiological marker rather than a stand-alone prognostic tool in patients undergoing mechanical thrombectomy.</p>

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Arterial Blood Gas Dynamics and Clinical Outcomes After Mechanical Thrombectomy in Acute Ischemic Stroke

  • 期刊论文

  • 发表日期：

    2026年1月21日

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  • Buket Özkara Yılmaz,
  • Ramazan Şencan,
  • Burak Akpek,
  • Erman Altunışık

摘要

Objective

This study aimed to evaluate the temporal changes in arterial blood gas (ABG) parameters and their relationship with clinical and radiological outcomes in patients undergoing mechanical thrombectomy due to acute ischemic stroke.

Materials and methods

A total of 65 patients (mean age: 67.7 ± 14.4 years) who underwent mechanical thrombectomy for anterior circulation large-vessel occlusion at Gaziantep City Hospital were included. Arterial blood gas parameters (pH, SaO₂, PaCO₂, PaO₂, lactate, HCO₃⁻) were recorded before thrombectomy and at the 1st, 3rd, and 5th hours after the procedure. Clinical outcomes were assessed using NIH Stroke Scale (NIHSS) scores, Alberta Stroke Program Early CT Scores (ASPECTS), modified Rankin Scale (mRS) at 3 months, and the presence of hemorrhagic transformation according to ECASS-II criteria.

Results

No significant correlation was found between serial ABG parameters and 3-month functional outcome (mRS). In robust regression analysis, higher pre-procedural pH was significantly associated with higher post-procedural ASPECTS (β = 0.737, p = 0.017), whereas elevated pre-procedural lactate levels were significantly associated with lower post- procedural ASPECTS (β = − 2.326, p < 0.001). In multivariable logistic regression, only baseline NIHSS (OR = 1.21, 95% CI: 1.01–1.44, p = 0.035) and hemorrhagic transformation (OR = 13.94, 95% CI: 2.16–90.18, p = 0.006) were independently associated with poor functional outcome (3-month mRS ≥ 3); ABG parameters did not retain independent predictive value.

Conclusion

Although certain pre-thrombectomy ABG parameters, particularly pH and lactate, were associated with neuroimaging markers of tissue integrity, arterial blood gas measurements did not independently predict long-term functional outcome. Initial neurological severity and hemorrhagic transformation remained the key determinants of prognosis. ABG monitoring may therefore be considered an adjunctive physiological marker rather than a stand-alone prognostic tool in patients undergoing mechanical thrombectomy.