The potential of biomarkers to predict futile recanalization in stroke patients receiving endovascular treatment

Objectives: This study aimed to investigate the relationships between serum S100 calcium binding protein, neuron-specific enolase, matrix metalloproteinase-9, interleukin-6, N-terminal probrain natriuretic peptide, and N-methyl-D-aspartate receptor subunit NR2 biomarkers and futile recanalization in patients with acute ischemic stroke who were successfully recanalized with endovascular treatment. Patients and methods: In this study, 44 patients (25 males, 19 females; mean age: 62.2±14.1 years; range, 26 to 81 years) with acute ischemic stroke due to acute anterior circulation large-vessel occlusion were prospectively analyzed between May 15, 2020 and October 15, 2020. Blood samples were taken at admission, as well as 6 and 24 h after endovascular treatment. A modified Rankin Scale (mRS) was used on the 90 th day to identify futile reperfusion. Patients with mRS scores ≤2 were included in the favorable reperfusion group (n=20), while patients with mRS scores ≥3 were considered to exhibit futile reperfusion (n=24). Results: There were no significant differences between the biomarker levels of the groups (p>0.05). There was no statistically significant correlation between biomarkers and 90-day mRS scores (p>0.05). Higher National Institute of Health Stroke Scale (NIHSS) scores (p=0.004), higher number of retriever passes (p=0.032), and higher diastolic blood pressure (p=0.037) were associated with futile recanalization. Multivariate logistic regression analysis showed that a higher NIHSS score at admission was an independent predictor of futile recanalization (odds ratio=1.216, 95% confidence interval 1.01-1.46, p=0.038). Conclusion: A higher NIHSS score at admission was an independent predictor for futile recanalization. However, we concluded that biomarker levels were not associated with futile recanalization.