BACKGROUND: Successful target vessel recanalization in patients with large vessel occlusion stroke is associated with favorable clinical outcomes. Conversely, unsuccessful recanalization (UR) is associated with higher chances of poor outcomes. UR occurs in up to 30% of endovascular thrombectomy (EVT) procedures, and there are significant knowledge gaps in identifying factors associated with UR. METHODS: Prospectively enrolled EVT-treated patients from the EVATRISP registry, which included patients from 18 academic medical centers across Europe between the years 2015 and 2024, were retrospectively studied. Patients had to have data on prestroke and 3-month functional status and recanalization status at the end of EVT. UR was defined as a modified Thrombolysis in Cerebral Infarction score <2b and compared with successful recanalization (modified Thrombolysis in Cerebral Infarction ≥2b). Regression analyses were performed to identify predictors of UR, and a predictive tool was subsequently constructed. RESULTS: <0.001). CONCLUSIONS: UR is frequent among patients undergoing EVT and is associated with poor clinical outcomes. Although several pre-EVT factors were independently associated with UR, accurately predicting which patients will experience UR remains highly challenging. Our findings suggest that all eligible patients should undergo EVT.
Schwartzmann et al. (Wed,) studied this question.