{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T03:47:17Z","timestamp":1777520837239,"version":"3.51.4"},"reference-count":31,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,2,28]],"date-time":"2025-02-28T00:00:00Z","timestamp":1740700800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Brain and Behavior"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>In endovascular therapy (EVT) for stroke, futile recanalization contributes to poor prognosis. Mild hypercapnia may enhance cerebral blood flow and prevent ischemia, but its impact on prognosis in successfully recanalized EVT patients is unclear.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively analyzed 237 patients from the INSPIRE database who underwent successful recanalization at our center (October 2018\u2013March 2022). Patients were grouped by post\u2010EVT PaCO<jats:sub>2<\/jats:sub> levels: high (40\u201350\u00a0mmHg) and low (&lt;40\u00a0mmHg). Significant infarct expansion (SIE) was defined as a decrease in ASPECTS or pc\u2010ASPECTS by \u22652 from initial to 3\u20135 days post\u2010EVT. Poor outcome was modified Rankin Scale score 3\u20136 at 90 days.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>High PaCO<jats:sub>2<\/jats:sub> was negatively associated with SIE (OR 0.42, 95% CI 0.22 to 0.84) and poor outcome (OR 0.42, 95% CI 0.20 to 0.87). Mediation analysis showed a significant total effect of high PaCO<jats:sub>2<\/jats:sub> on poor outcome (coefficient \u22120.192, 95% CI \u22120.345 to \u22120.046), including an indirect effect mediated by SIE (coefficient \u22120.055, 95% CI \u22120.10 to \u22120.006). These associations were consistent in anterior circulation stroke and patients without severe low PaCO<jats:sub>2<\/jats:sub> (&lt;30\u00a0mmHg).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Maintaining mild hypercapnia (PaCO<jats:sub>2<\/jats:sub> 40\u201350\u00a0mmHg) after EVT may prevent poor outcomes by reducing post\u2010EVT infarct progression.<\/jats:p><\/jats:sec>","DOI":"10.1002\/brb3.70347","type":"journal-article","created":{"date-parts":[[2025,3,8]],"date-time":"2025-03-08T20:22:48Z","timestamp":1741465368000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Post\u2010Thrombectomy Mild Hypercapnia State Prevents Poor Outcome by Reducing Infarct Progression"],"prefix":"10.1002","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-8219-2665","authenticated-orcid":false,"given":"Peng","family":"Jiang","sequence":"first","affiliation":[{"name":"Center for 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