Alterations in Local Peri-Infarct Blood Gases in Stroke Patients Undergoing Thrombectomy

Robert Christopher Spears; Christopher J. McLouth; Keith R. Pennypacker; Jacqueline A. Frank; Benton Maglinger; Sarah Martha; Amanda L. Trout; Jill Roberts; Ann M. Stowe; Lila Sheikhi; Shivani Pahwa; Justin F. Fraser

doi:10.1016/j.wneu.2021.10.171

Alterations in Local Peri-Infarct Blood Gases in Stroke Patients Undergoing Thrombectomy

Robert Christopher Spears
, Christopher J. McLouth
, Keith R. Pennypacker
, Jacqueline A. Frank
, Benton Maglinger
, Sarah Martha
, Amanda L. Trout
, Jill Roberts
, Ann M. Stowe
, Lila Sheikhi
, Shivani Pahwa
, Justin F. Fraser

Research output: Contribution to journal › Article › peer-review

8 Scopus citations

Abstract

Background: Ischemic stroke is a prevalent, devastating disease with high morbidity and mortality. Despite extensive research using animal models, significant gaps remain in understanding the pathological processes in human stroke. We previously developed a tissue bank to analyze the blood immediately proximal and distal to an intracranial thrombus in patients undergoing mechanical thrombectomy (ClinicalTrials.gov identifier, NCT03153683). Our goal for the present project was to evaluate the blood gas changes and acid/base balance during stroke and determine how vascular collateralization affects these changes. Methods: We analyzed the blood samples and computed tomography angiography collateral scores from the first 62 patients in the BACTRAC (Blood and Clot Thrombectomy Registry and Collaboration) registry. The bicarbonate, partial pressure of oxygen, and partial pressure of carbon dioxide (pCO₂) values of the intracranial (distal) and systemic (proximal) arterial blood relative to the occlusive thrombus were analyzed. Analysis of the group differences in systemic and intracranial blood gas values was also performed. Results: The partial pressure of oxygen, pCO₂, and bicarbonate levels were all significantly higher in the systemic blood than in the intracranial blood (P < 0.001 for all) at thrombectomy. Collateralization did not significantly affect the distal blood gas values. Compared with the female patients, the male patients had had higher systemic pCO₂ values (39.8 vs. 36.6 mm Hg; P = 0.0065) and lower systemic and intracranial pH values (7.351 vs. 7.392; P = 0.0047). Conclusions: The arterial blood gases differed immediately proximal and distal to thrombi in large vessel occlusive stroke. Although vascular collateralization did not appear to affect the blood gas changes, some blood gas values differed between men and women. The changes in bicarbonate and pCO₂ suggested a compensatory acid-base process occurring at the time of infarction.

Original language	English
Pages (from-to)	e317-e322
Journal	World Neurosurgery
Volume	158
DOIs	https://doi.org/10.1016/j.wneu.2021.10.171
State	Published - Feb 2022

Bibliographical note

Publisher Copyright:
© 2021 Elsevier Inc.

Funding

The authors would like to thank the BACTRAC study team and Mary Faulkner for her exceptional service as the BACTRAC study coordinator. Conflict of interest statement: Ann M. Stowe and Keith R. Pennypacker have ownership in Cerelux. Justin F. Fraser has ownership in Cerelux and Fawkes Biotechnology. The remaining authors declare that the article content was composed in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

Arterial blood gas
Endovascular
Ischemic stroke
Thrombectomy
Vascular

ASJC Scopus subject areas

Surgery
Clinical Neurology

Access to Document

10.1016/j.wneu.2021.10.171

Cite this

@article{96fbdd72e0d84b9094b74abccdceb234,

title = "Alterations in Local Peri-Infarct Blood Gases in Stroke Patients Undergoing Thrombectomy",

abstract = "Background: Ischemic stroke is a prevalent, devastating disease with high morbidity and mortality. Despite extensive research using animal models, significant gaps remain in understanding the pathological processes in human stroke. We previously developed a tissue bank to analyze the blood immediately proximal and distal to an intracranial thrombus in patients undergoing mechanical thrombectomy (ClinicalTrials.gov identifier, NCT03153683). Our goal for the present project was to evaluate the blood gas changes and acid/base balance during stroke and determine how vascular collateralization affects these changes. Methods: We analyzed the blood samples and computed tomography angiography collateral scores from the first 62 patients in the BACTRAC (Blood and Clot Thrombectomy Registry and Collaboration) registry. The bicarbonate, partial pressure of oxygen, and partial pressure of carbon dioxide (pCO2) values of the intracranial (distal) and systemic (proximal) arterial blood relative to the occlusive thrombus were analyzed. Analysis of the group differences in systemic and intracranial blood gas values was also performed. Results: The partial pressure of oxygen, pCO2, and bicarbonate levels were all significantly higher in the systemic blood than in the intracranial blood (P < 0.001 for all) at thrombectomy. Collateralization did not significantly affect the distal blood gas values. Compared with the female patients, the male patients had had higher systemic pCO2 values (39.8 vs. 36.6 mm Hg; P = 0.0065) and lower systemic and intracranial pH values (7.351 vs. 7.392; P = 0.0047). Conclusions: The arterial blood gases differed immediately proximal and distal to thrombi in large vessel occlusive stroke. Although vascular collateralization did not appear to affect the blood gas changes, some blood gas values differed between men and women. The changes in bicarbonate and pCO2 suggested a compensatory acid-base process occurring at the time of infarction.",

keywords = "Arterial blood gas, Endovascular, Ischemic stroke, Thrombectomy, Vascular",

author = "Spears, \{Robert Christopher\} and McLouth, \{Christopher J.\} and Pennypacker, \{Keith R.\} and Frank, \{Jacqueline A.\} and Benton Maglinger and Sarah Martha and Trout, \{Amanda L.\} and Jill Roberts and Stowe, \{Ann M.\} and Lila Sheikhi and Shivani Pahwa and Fraser, \{Justin F.\}",

note = "Publisher Copyright: {\textcopyright} 2021 Elsevier Inc.",

year = "2022",

month = feb,

doi = "10.1016/j.wneu.2021.10.171",

language = "English",

volume = "158",

pages = "e317--e322",

}

TY - JOUR

T1 - Alterations in Local Peri-Infarct Blood Gases in Stroke Patients Undergoing Thrombectomy

AU - Spears, Robert Christopher

AU - McLouth, Christopher J.

AU - Pennypacker, Keith R.

AU - Frank, Jacqueline A.

AU - Maglinger, Benton

AU - Martha, Sarah

AU - Trout, Amanda L.

AU - Roberts, Jill

AU - Stowe, Ann M.

AU - Sheikhi, Lila

AU - Pahwa, Shivani

AU - Fraser, Justin F.

PY - 2022/2

Y1 - 2022/2

N2 - Background: Ischemic stroke is a prevalent, devastating disease with high morbidity and mortality. Despite extensive research using animal models, significant gaps remain in understanding the pathological processes in human stroke. We previously developed a tissue bank to analyze the blood immediately proximal and distal to an intracranial thrombus in patients undergoing mechanical thrombectomy (ClinicalTrials.gov identifier, NCT03153683). Our goal for the present project was to evaluate the blood gas changes and acid/base balance during stroke and determine how vascular collateralization affects these changes. Methods: We analyzed the blood samples and computed tomography angiography collateral scores from the first 62 patients in the BACTRAC (Blood and Clot Thrombectomy Registry and Collaboration) registry. The bicarbonate, partial pressure of oxygen, and partial pressure of carbon dioxide (pCO2) values of the intracranial (distal) and systemic (proximal) arterial blood relative to the occlusive thrombus were analyzed. Analysis of the group differences in systemic and intracranial blood gas values was also performed. Results: The partial pressure of oxygen, pCO2, and bicarbonate levels were all significantly higher in the systemic blood than in the intracranial blood (P < 0.001 for all) at thrombectomy. Collateralization did not significantly affect the distal blood gas values. Compared with the female patients, the male patients had had higher systemic pCO2 values (39.8 vs. 36.6 mm Hg; P = 0.0065) and lower systemic and intracranial pH values (7.351 vs. 7.392; P = 0.0047). Conclusions: The arterial blood gases differed immediately proximal and distal to thrombi in large vessel occlusive stroke. Although vascular collateralization did not appear to affect the blood gas changes, some blood gas values differed between men and women. The changes in bicarbonate and pCO2 suggested a compensatory acid-base process occurring at the time of infarction.

AB - Background: Ischemic stroke is a prevalent, devastating disease with high morbidity and mortality. Despite extensive research using animal models, significant gaps remain in understanding the pathological processes in human stroke. We previously developed a tissue bank to analyze the blood immediately proximal and distal to an intracranial thrombus in patients undergoing mechanical thrombectomy (ClinicalTrials.gov identifier, NCT03153683). Our goal for the present project was to evaluate the blood gas changes and acid/base balance during stroke and determine how vascular collateralization affects these changes. Methods: We analyzed the blood samples and computed tomography angiography collateral scores from the first 62 patients in the BACTRAC (Blood and Clot Thrombectomy Registry and Collaboration) registry. The bicarbonate, partial pressure of oxygen, and partial pressure of carbon dioxide (pCO2) values of the intracranial (distal) and systemic (proximal) arterial blood relative to the occlusive thrombus were analyzed. Analysis of the group differences in systemic and intracranial blood gas values was also performed. Results: The partial pressure of oxygen, pCO2, and bicarbonate levels were all significantly higher in the systemic blood than in the intracranial blood (P < 0.001 for all) at thrombectomy. Collateralization did not significantly affect the distal blood gas values. Compared with the female patients, the male patients had had higher systemic pCO2 values (39.8 vs. 36.6 mm Hg; P = 0.0065) and lower systemic and intracranial pH values (7.351 vs. 7.392; P = 0.0047). Conclusions: The arterial blood gases differed immediately proximal and distal to thrombi in large vessel occlusive stroke. Although vascular collateralization did not appear to affect the blood gas changes, some blood gas values differed between men and women. The changes in bicarbonate and pCO2 suggested a compensatory acid-base process occurring at the time of infarction.

KW - Arterial blood gas

KW - Endovascular

KW - Ischemic stroke

KW - Thrombectomy

KW - Vascular

UR - https://www.scopus.com/pages/publications/85120181846

UR - https://www.scopus.com/pages/publications/85120181846#tab=citedBy

U2 - 10.1016/j.wneu.2021.10.171

DO - 10.1016/j.wneu.2021.10.171

M3 - Article

C2 - 34728392

AN - SCOPUS:85120181846

SN - 1878-8750

VL - 158

SP - e317-e322

JO - World Neurosurgery

JF - World Neurosurgery

ER -

Alterations in Local Peri-Infarct Blood Gases in Stroke Patients Undergoing Thrombectomy

Abstract

Bibliographical note

Funding

UN SDGs

Keywords

ASJC Scopus subject areas

Access to Document

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