Prognostic factors for futile recanalization in acute anterior ischemic stroke patients

Abstract Background: More than half of the patients who underwent endovascular treatment for reperfusion had a poor prognosis. Our study aimed to investigate the factors associated with futile reperfusion following endovascular treatment in patients with acute ischemic stroke. Methods: This study conducted a postoperative analysis at Guangdong Province Second People's Hospital, focusing on patients with anterior circulation large-vessel occlusion who underwent endovascular treatment or a combination of intravenous thrombolysis from June 2019 to October 2023. Futile recanalization was determined based on a modified Rankin score of 3-6 at 90 days post-treatment. The researchers utilized multifactorial logistic regression to identify factors linked to futile recanalization following reperfusion in patients. Results: A total of 120 patients were enrolled, amongst which 52 patients (43.3%) had FR. After adjusting for confounders, the discharge NIHSS score, as a continuous variable, was associated with futile recanalization (per 1 score: aOR: 7.30,95%CI: 2.176-24.491, P=0.001), indicating an increased risk, hemorrhagic transformation was also associated with higher futile recanalization risk(aOR:8.556,95%CI: 11.038-70.549, P=0.046). Conclusion: In patients with large anterior circulation stroke, our findings suggest that the discharge INHSS score and hemorrhagic transformation are risk factors for FR.