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

Objective This study aimed to evaluate the temporal changes in arterial blood gas (ABG) parameters and their relationship with clinical 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) who underwent mechanical thrombectomy 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 post-thrombectomy. Clinical outcomes were assessed using pre- and post-treatment NIHSS scores, ASPECT scores, modified Rankin Scale (mRS) scores, and the presence of hemorrhage based on ECASS-II criteria. Results No significant correlation was found between arterial blood gas parameters and clinical outcome scores (NIHSS and 3-month mRS). However, an increase in preprocedural pH was significantly associated with higher post-procedural ASPECT scores (β = 0.737, p = 0.017), while elevated preprocedural lactate levels were significantly associated with lower post-ASPECT scores (β = − 2.326, p < 0.001). The most significant predictors of poor clinical outcome (3-month mRS ≥ 3) were higher baseline NIHSS (p = 0.019) and lower post-ASPECT scores (p = 0.019). Temporal changes in ABG parameters showed no significant effect on mRS scores. Conclusion Although certain pre-thrombectomy ABG parameters (particularly pH and lactate) are associated with neuroimaging findings, their independent predictive value for clinical outcomes appears limited. ABG monitoring may contribute to prognostic evaluation, yet its direct impact on functional outcome (mRS) is weak.