{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T10:02:58Z","timestamp":1789984978553,"version":"4.0.1"},"reference-count":31,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T00:00:00Z","timestamp":1783036800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"vor","delay-in-days":80,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100003785","name":"Guangdong Medical Research Foundation","doi-asserted-by":"publisher","award":["A2024137 and A2025080"],"award-info":[{"award-number":["A2024137 and A2025080"]}],"id":[{"id":"10.13039\/501100003785","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Research Project of Heyuan People's Hospital","award":["YNKT202221"],"award-info":[{"award-number":["YNKT202221"]}]},{"name":"Clinical Research Special Fund of Heyuan Medical Association","award":["2023007"],"award-info":[{"award-number":["2023007"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Neurol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>There is relatively little data on malignant brain edema (MBE) after mechanical thrombectomy (MT) in non cardioembolic acute cerebral infarction caused by anterior circulation large vessel occlusion. Our study attempts to investigate the incidence rate of MBE after successful MT of anterior circulation acute non cardioembolic cerebral infarction, the predictive effect of emergency preoperative plasma D-dimer and clinical prognosis of patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>One hundred eighty-six consecutive patients suffered from anterior circulation non cardioembolic acute cerebral infarction who received successful MT were selected. Clinical features, imaging examinations, laboratory tests and treatment characteristics of patients at admission were collected and analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 186 patients (aged 64.26 \u00b1 11.62 years; male accounted for 75.81%), 30 cases (16.13%) developed MBE. MBE patients had a low 3-month good prognosis rate and a high mortality rate (\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001). After adjusting for confounding factors, ASPECT score at admission (OR=0.322; 95% CI 0.146-0.711;\n                      <jats:italic>P<\/jats:italic>\n                      =0.005), tandem lesions in the location of occluded vessel (OR=6.422; 95% CI 1.799-22.924;\n                      <jats:italic>P<\/jats:italic>\n                      =0.004), collateral circulation score (OR=0.343; 95% CI 0.139-0.845;\n                      <jats:italic>P<\/jats:italic>\n                      =0.020) and emergency preoperative plasma D-dimer (OR=1.155; 95% CI 1.004-1.329;\n                      <jats:italic>P<\/jats:italic>\n                      =0.044) were significantly related to MBE. The area under the ROC curve of predicting MBE using emergency preoperative plasma D-dimer was 0.706 (sensitivity 0.500; specificity 0.859).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Emergency preoperative plasma D-dimer is associated with MBE in patients with noncardioembolic acute cerebral infarction of anterior circulation after successful MT, although its predictive performance is modest. The presence of MBE reduces the chance of patients' neurological independence at 3 months after MT. These findings are preliminary and require validation in larger prospective studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12883-026-05139-2","type":"journal-article","created":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T02:41:59Z","timestamp":1783046519000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Plasma D-dimer can predict malignant brain edema after thrombectomy in noncardioembolic acute cerebral infarction"],"prefix":"10.1186","volume":"26","author":[{"given":"Wensheng","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhenqin","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yangchun","family":"Wen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaojing","family":"Zhong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minzhen","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Ling","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weifang","family":"Xing","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,3]]},"reference":[{"issue":"10","key":"5139_CR1","doi-asserted-by":"publisher","first-page":"895","DOI":"10.1016\/S1474-4422(18)30242-4","volume":"17","author":"LS Rom\u00e1n","year":"2018","unstructured":"Rom\u00e1n LS, Menon BK, Blasco J, et al. Imaging features and safety and efficacy of endovascular stroke treatment: a meta-analysis of individual patient-level data. Lancet Neurol. 2018;17(10):895\u2013904.","journal-title":"Lancet Neurol"},{"issue":"12","key":"5139_CR2","doi-asserted-by":"publisher","first-page":"3416","DOI":"10.1161\/STROKEAHA.115.011397","volume":"46","author":"JP Broderick","year":"2015","unstructured":"Broderick JP, Berkhemer OA, Palesch YY, et al. Endovascular Therapy Is Effective and Safe for Patients With Severe Ischemic Stroke: Pooled Analysis of Interventional Management of Stroke III and Multicenter Randomized Clinical Trial of Endovascular Therapy for Acute Ischemic Stroke in the Netherlands Data. Stroke. 2015;46(12):3416\u201322.","journal-title":"Stroke"},{"issue":"1","key":"5139_CR3","doi-asserted-by":"publisher","first-page":"126","DOI":"10.1111\/ijs.12206","volume":"9","author":"BC Campbell","year":"2014","unstructured":"Campbell BC, Mitchell PJ, Yan B, et al. A multicenter, randomized, controlled study to investigate EXtending the time for Thrombolysis in Emergency Neurological Deficits with Intra-Arterial therapy (EXTEND-IA). Int J Stroke. 2014;9(1):126\u201332.","journal-title":"Int J Stroke"},{"key":"5139_CR4","doi-asserted-by":"publisher","first-page":"881","DOI":"10.1136\/neurintsurg-2021-017963","volume":"14","author":"G Deng","year":"2022","unstructured":"Deng G, Xiao J, Yu H, et al. Predictors of futile recanalization after endovascular treatment in acute ischemic Stroke: a meta-analysis. J Neurointerv Surg. 2022;14:881\u201385.","journal-title":"J Neurointerv Surg"},{"issue":"3","key":"5139_CR5","doi-asserted-by":"publisher","first-page":"873","DOI":"10.1161\/STROKEAHA.122.038466","volume":"54","author":"X Nie","year":"2023","unstructured":"Nie X, Leng X, Miao Z, et al. Clinically Ineffective Reperfusion After Endovascular Therapy in Acute Ischemic Stroke. Stroke. 2023;54(3):873\u201381.","journal-title":"Stroke"},{"key":"5139_CR6","doi-asserted-by":"publisher","first-page":"835915","DOI":"10.3389\/fimmu.2022.835915","volume":"13","author":"C Liu","year":"2022","unstructured":"Liu C, Li F, Liu S, et al. Neutrophil Count Predicts Malignant Cerebellar Edema and Poor Outcome in Acute Basilar Artery Occlusion Receiving Endovascular Treatment: A Nationwide Registry-Based Study. Front Immunol. 2022;13:835915.","journal-title":"Front Immunol"},{"issue":"10","key":"5139_CR7","doi-asserted-by":"publisher","first-page":"994","DOI":"10.1136\/neurintsurg-2018-014650","volume":"11","author":"X Huang","year":"2019","unstructured":"Huang X, Yang Q, Shi X, et al. Predictors of malignant brain edema after mechanical thrombectomy for acute ischemic stroke. J Neurointerv Surg. 2019;11(10):994\u20138.","journal-title":"J Neurointerv Surg"},{"issue":"1","key":"5139_CR8","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1227\/NEU.0000000000001735","volume":"90","author":"GJ Cannarsa","year":"2022","unstructured":"Cannarsa GJ, Wessell AP, Chryssikos T, et al. Initial Stress Hyperglycemia Is Associated With Malignant Cerebral Edema, Hemorrhage, and Poor Functional Outcome After Mechanical Thrombectomy. Neurosurgery. 2022;90(1):66\u201371.","journal-title":"Neurosurgery"},{"issue":"6","key":"5139_CR9","doi-asserted-by":"publisher","first-page":"107139","DOI":"10.1016\/j.jstrokecerebrovasdis.2023.107139","volume":"32","author":"M Pu","year":"2023","unstructured":"Pu M, Chen J, Chen Z, et al. Predictors and outcome of malignant cerebral edema after successful reperfusion in anterior circulation stroke. J Stroke Cerebrovasc Dis. 2023;32(6):107139.","journal-title":"J Stroke Cerebrovasc Dis"},{"key":"5139_CR10","doi-asserted-by":"publisher","first-page":"e548","DOI":"10.1016\/j.wneu.2023.02.091","volume":"173","author":"Y He","year":"2023","unstructured":"He Y, Zuo M, Huang J, et al. A Novel Nomogram for Predicting Malignant Cerebral Edema After Endovascular Thrombectomy in Acute Ischemic Stroke: A Retrospective Cohort Study. World Neurosurg. 2023;173:e548\u201358.","journal-title":"World Neurosurg"},{"issue":"12","key":"5139_CR11","doi-asserted-by":"publisher","first-page":"1438","DOI":"10.1016\/j.amjmed.2018.08.006","volume":"131","author":"W Sendama","year":"2018","unstructured":"Sendama W, Musgrave KM. Decision-Making with D-Dimer in the Diagnosis of Pulmonary Embolism. Am J Med. 2018;131(12):1438\u201343.","journal-title":"Am J Med"},{"issue":"4","key":"5139_CR12","doi-asserted-by":"publisher","first-page":"275","DOI":"10.1097\/00063198-199707000-00007","volume":"3","author":"AY Lee","year":"1997","unstructured":"Lee AY, Ginsberg JS. The role of D-dimer in the diagnosis of venous thromboembolism. Curr Opin Pulm Med. 1997;3(4):275\u20139.","journal-title":"Curr Opin Pulm Med"},{"issue":"3","key":"5139_CR13","doi-asserted-by":"publisher","first-page":"852","DOI":"10.1161\/STROKEAHA.120.031657","volume":"52","author":"A Ramos-Pach\u00f3n","year":"2021","unstructured":"Ramos-Pach\u00f3n A, L\u00f3pez-Cancio E, Bustamante A, et al. D-Dimer as Predictor of Large Vessel Occlusion in Acute Ischemic Stroke. Stroke. 2021;52(3):852\u20138.","journal-title":"Stroke"},{"issue":"21","key":"5139_CR14","doi-asserted-by":"publisher","first-page":"e1955","DOI":"10.1212\/WNL.0000000000008520","volume":"93","author":"OY Bang","year":"2019","unstructured":"Bang OY, Chung JW, Kim SK, et al. Therapeutic-induced hypertension in patients with noncardioembolic acute stroke. Neurology. 2019;93(21):e1955\u201363.","journal-title":"Neurology"},{"issue":"15","key":"5139_CR15","doi-asserted-by":"publisher","first-page":"e012652","DOI":"10.1161\/JAHA.119.012652","volume":"8","author":"J Aoki","year":"2019","unstructured":"Aoki J, Iguchi Y, Urabe T, et al. Acute Aspirin Plus Cilostazol Dual Therapy for Noncardioembolic Stroke Patients Within 48 Hours of Symptom Onset. J Am Heart Assoc. 2019;8(15):e012652.","journal-title":"J Am Heart Assoc"},{"issue":"4","key":"5139_CR16","doi-asserted-by":"publisher","first-page":"1190","DOI":"10.1161\/STROKEAHA.119.027569","volume":"51","author":"KS Butcher","year":"2020","unstructured":"Butcher KS, Ng K, Sheridan P, et al. Dabigatran Treatment of Acute Noncardioembolic Ischemic Stroke. Stroke. 2020;51(4):1190\u20138.","journal-title":"Stroke"},{"issue":"9","key":"5139_CR17","doi-asserted-by":"publisher","first-page":"e933","DOI":"10.1212\/WNL.0000000000207538","volume":"101","author":"M Sykora","year":"2023","unstructured":"Sykora M, Krebs S, Miksova D, et al. IV Thrombolysis vs Early Dual Antiplatelet Therapy in Patients With Mild Noncardioembolic Ischemic Stroke. Neurology. 2023;101(9):e933\u20139.","journal-title":"Neurology"},{"issue":"2","key":"5139_CR18","doi-asserted-by":"publisher","first-page":"401","DOI":"10.1007\/s00062-021-01068-4","volume":"32","author":"P Hendrix","year":"2022","unstructured":"Hendrix P, Melamed I, Collins M, et al. NIHSS 24\u00a0h After Mechanical Thrombectomy Predicts 90-Day Functional Outcome. Clin Neuroradiol. 2022;32(2):401\u20136.","journal-title":"Clin Neuroradiol"},{"issue":"e2","key":"5139_CR19","doi-asserted-by":"publisher","first-page":"e206","DOI":"10.1136\/jnis-2024-022677","volume":"17","author":"C Cunningham","year":"2025","unstructured":"Cunningham C, Hubbard Z, Abo Kasem R, et al. Mechanical thrombectomy in elderly stroke patients with low ASPECTS: insights from STAR. J Neurointerv Surg. 2025;17(e2):e206\u201315.","journal-title":"J Neurointerv Surg"},{"issue":"1","key":"5139_CR20","doi-asserted-by":"publisher","first-page":"460","DOI":"10.1186\/s12883-022-02996-5","volume":"22","author":"P Pan","year":"2022","unstructured":"Pan P, Xu X, Fei M, et al. Y, et al. Influence of tirofiban on stroke outcome after mechanical thrombectomy in acute vertebrobasilar artery occlusion. BMC Neurol. 2022;22(1):460. https:\/\/doi.org\/10.1186\/s12883-022-02996-5. Erratum in: BMC Neurol. 2022;22(1):502.","journal-title":"BMC Neurol"},{"issue":"9","key":"5139_CR21","doi-asserted-by":"publisher","first-page":"2650","DOI":"10.1161\/STROKEAHA.113.001972","volume":"44","author":"OO Zaidat","year":"2013","unstructured":"Zaidat OO, Yoo AJ, Khatri P, et al. Recommendations on angiographic revascularization grading standards for acute ischemic stroke: a consensus statement. Stroke. 2013;44(9):2650\u201363.","journal-title":"Stroke"},{"issue":"5","key":"5139_CR22","doi-asserted-by":"publisher","first-page":"433","DOI":"10.1136\/neurintsurg-2018-014127","volume":"11","author":"DS Liebeskind","year":"2019","unstructured":"Liebeskind DS, Bracard S, Guillemin F, et al. eTICI reperfusion: defining success in endovascular stroke therapy. J Neurointerv Surg. 2019;11(5):433\u20138.","journal-title":"J Neurointerv Surg"},{"issue":"4","key":"5139_CR23","doi-asserted-by":"publisher","first-page":"285","DOI":"10.1136\/svn-2021-001093","volume":"7","author":"X Sun","year":"2022","unstructured":"Sun X, Zhang J, Tong X, et al. A comparison between acute large vessel occlusion in the posterior circulation and anterior circulation after endovascular treatment: the ANGEL-ACT registry experience. Stroke Vasc Neurol. 2022;7(4):285\u201393.","journal-title":"Stroke Vasc Neurol"},{"issue":"3","key":"5139_CR24","doi-asserted-by":"publisher","first-page":"150","DOI":"10.2174\/157340310791658730","volume":"6","author":"A Arboix","year":"2010","unstructured":"Arboix A, Ali\u00f3 J. Cardioembolic stroke: clinical features, specific cardiac disorders and prognosis. Curr Cardiol Rev. 2010;6(3):150\u201361.","journal-title":"Curr Cardiol Rev"},{"issue":"e3","key":"5139_CR25","doi-asserted-by":"publisher","first-page":"e363","DOI":"10.1136\/jnis-2022-019874","volume":"15","author":"X Yang","year":"2023","unstructured":"Yang X, Sun D, Huo X, et al. Futile reperfusion of endovascular treatment for acute anterior circulation large vessel occlusion in the ANGEL-ACT registry. J Neurointerv Surg. 2023;15(e3):e363\u20138.","journal-title":"J Neurointerv Surg"},{"issue":"e3","key":"5139_CR26","doi-asserted-by":"publisher","first-page":"e375","DOI":"10.1136\/jnis-2022-019719","volume":"15","author":"K Qiu","year":"2023","unstructured":"Qiu K, Jia ZY, Cao Y, et al. Emergency admission plasma D-dimer: a novel predictor for symptomatic intracranial hemorrhage after thrombectomy in acute ischemic stroke. J Neurointerv Surg. 2023;15(e3):e375\u201380.","journal-title":"J Neurointerv Surg"},{"key":"5139_CR27","doi-asserted-by":"publisher","first-page":"101977","DOI":"10.1016\/j.eclinm.2023.101977","volume":"59","author":"S Wu","year":"2023","unstructured":"Wu S, Wang Y, Yuan R, et al. Predicting the emergence of malignant brain oedema in acute ischaemic stroke: a prospective multicentre study with development and validation of predictive modelling. EClinicalMedicine. 2023;59:101977.","journal-title":"EClinicalMedicine"},{"issue":"4","key":"5139_CR28","doi-asserted-by":"publisher","first-page":"909","DOI":"10.1161\/STROKEAHA.118.023316","volume":"50","author":"M Cappellari","year":"2019","unstructured":"Cappellari M, Mangiafico S, Saia V, et al. IER-SICH Nomogram to Predict Symptomatic Intracerebral Hemorrhage After Thrombectomy for Stroke. Stroke. 2019;50(4):909\u201316.","journal-title":"Stroke"},{"issue":"12","key":"5139_CR29","first-page":"1370","volume":"90","author":"M Montalvo","year":"2019","unstructured":"Montalvo M, Mistry E, Chang AD, et al. Predicting symptomatic intracranial haemorrhage after mechanical thrombectomy: the TAG score. J Neurol Neurosurg Psychiatry. 2019;90(12):1370\u20134.","journal-title":"J Neurol Neurosurg Psychiatry"},{"issue":"4","key":"5139_CR30","doi-asserted-by":"publisher","first-page":"461","DOI":"10.1007\/s00234-019-02180-6","volume":"61","author":"U Neuberger","year":"2019","unstructured":"Neuberger U, Kickingereder P, Sch\u00f6nenberger S, et al. Risk factors of intracranial hemorrhage after mechanical thrombectomy of anterior circulation ischemic stroke. Neuroradiology. 2019;61(4):461\u20139.","journal-title":"Neuroradiology"},{"key":"5139_CR31","doi-asserted-by":"publisher","first-page":"113902","DOI":"10.1016\/j.intimp.2024.113902","volume":"146","author":"W Lu","year":"2025","unstructured":"Lu W, Wen J. The relationship among H2S, neuroinflammation and MMP-9 in BBB injury following ischemic stroke. Int Immunopharmacol. 2025;146:113902.","journal-title":"Int Immunopharmacol"}],"container-title":["BMC Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12883-026-05139-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12883-026-05139-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12883-026-05139-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T09:16:53Z","timestamp":1789982213000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12883-026-05139-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,3]]},"references-count":31,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["5139"],"URL":"https:\/\/doi.org\/10.1186\/s12883-026-05139-2","relation":{},"ISSN":["1471-2377"],"issn-type":[{"value":"1471-2377","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,3]]},"assertion":[{"value":"10 July 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 June 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 July 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"In accordance with the Declaration of Helsinki, approval was obtained from the Medical Ethics Committee of Heyuan People\u2019s Hospital (YXYJLL-YJZFQ33). The medical ethics committee agree to waive written informed consent for this study.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"597"}}