Chinese expert consensus on critical care management of neurological complications after endovascular treatment for acute ischemic stroke

doi:10.3969/j.issn.1672-6731.2025.10.003

Abstract

Abstract:

The monitoring, evaluation and critical care management of neurological complications after endovascular treatment for acute ischemic stroke are essential components in optimizing patient outcomes and reducing both disability and mortality rates. Neurological complications, such as hemorrhagic transformation, vessel reocclusion, malignant brain edema and post-stroke epilepsy, which occur after endovascular treatment can significantly influence the overall effectiveness of the treatment. However, current critical care management of neurological complications are often hindered by inconsistencies in management standards and lack of standardized protocols. This expert consensus, grounded in evidence-based medicine and incorporating the clinical insights of professionals from multiple disciplines, provides a systematic approach to key areas including the identification of risk factors, appropriate monitoring and evaluation, and effective critical care management strategies for the most common postoperative neurological complications. Together, these elements form a comprehensive and standardized management framework. The primary goal of this consensus is to deliver scientifically sound and clinically applicable guidance for neurological complications management after endovascular treatment in patients with acute ischemic stroke.

Key words: Ischemic stroke, Endovascular procedures, Postoperative complications, Intracranial hemorrhages, Brain edema, Critical care, Diagnostic and treatment guideline, China

摘要：

急性缺血性卒中血管内治疗后神经系统并发症的监测评估与重症管理是改善患者预后、降低病残率和病死率的重要环节。血管内治疗后发生的出血转化、血管再闭塞、恶性脑水肿、脑卒中后癫痫等神经系统并发症严重影响治疗效果。鉴于当前神经系统并发症管理存在的标准不统一、流程不规范等问题，《急性缺血性卒中血管内治疗后神经系统并发症重症管理中国专家共识》以循证医学证据为基础，融合多学科专家临床经验，围绕术后常见神经系统并发症的危险因素、监测评估及重症管理策略等核心要点进行系统梳理，形成全面、规范的管理方案，旨在为急性缺血性卒中血管内治疗后神经系统并发症重症管理提供科学、实用的临床指导。

关键词: 缺血性卒中, 血管内操作, 手术后并发症, 颅内出血, 脑水肿, 危重病人医疗, 诊疗指南, 中国

Chinese Neurosurgical Intensive Care Management Collaborative Group, Minimally Invasive and Non-Invasive Professional Committee of Chinese Research Hospital Association, He'nan Provincial Stroke Association. Chinese expert consensus on critical care management of neurological complications after endovascular treatment for acute ischemic stroke[J]. Chinese Journal of Contemporary Neurology and Neurosurgery, 2025, 25(10): 885-899.

中国神经外科重症管理协作组, 中国研究型医院学会微无创诊疗专业委员会, 河南省卒中学会. 急性缺血性卒中血管内治疗后神经系统并发症重症管理中国专家共识[J]. 中国现代神经疾病杂志, 2025, 25(10): 885-899.

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