Résumé
Acute ischemic stroke (AIS) is a major global cause of mortality and disability. Mechanical thrombectomy (MT), the gold standard treatment for AIS due to large vessel occlusion (LVO), enables rapid cerebral reperfusion. However, AIS triggers an inflammatory response that can influence neurological outcomes. Understanding the presence and evolution of inflammatory markers during AIS could enhance our knowledge of its pathophysiology and inform therapeutic strategies. This study aimed to determine the presence and evolution of inflammatory markers over 48 hours post-MT, assess the feasibility of monitoring these markers through peripheral blood samples, and explore the potential influence of anesthesia type on neuroinflammation. Materials and methods: adult patients with AIS due to LVO of the anterior circulation primarily admitted to the Montpellier University Hospital and treated by MT were included. Two anesthesia protocols were used: General Anesthesia (GA) with Sevoflurane or Local Anesthesia (LA) with Remifentanil sedation. Peripheral blood samples were collected at five timepoints: before MT and 15 minutes, 6 hours, 24 hours and 48 hours post-recanalization of the occluded vessel. Biomarkers were quantified using the Meso Scale Discovery method. The evolution of biomarkers was assessed using Linear Mixed Models (LMM) to determine the effects of time, anesthesia and other confounding factors. Correlation between biomarkers and the 90-day modified Rankin Scale (mRS) score was evaluated using Spearman correlation analysis and LMM. Results: a total of 50 patients undergoing MT were analyzed. Several inflammatory biomarkers were detectable in peripheral blood and showed significant temporal evolution over 48 hours. Significant correlations were observed between certain biomarkers (IFN- γ, IL-10, IL-6, SAA, VCAM-1) and the 90-day mRS score, suggesting their potential prognostic value. The type of anesthesia significantly affected IL-10 levels (p=0.007) and showed a borderline significance for IFN-γ (p=0.071), indicating that anesthesia may influence neuroinflammatory responses. Conclusion: inflammatory biomarkers are present and evolve during the acute phase of AIS and can be effectively monitored through peripheral blood samples. The associations between specific biomarkers and neurological outcomes underscore the importance of inflammation in stroke recovery. While the impact of anesthesia type on biomarkers was limited, the findings warrant further research into its role in neuroinflammation. These insights may guide future therapeutic interventions targeting cytokine modulation to improve outcomes in AIS patients.