Randomized trial quantifies the impact of hypoperfusion intensity ratio on futile reperfusion in stroke patients, indicating important prognostic relationships.
Key Points
This research investigates how hypoperfusion intensity ratio (HIR) influences futile reperfusion (FR) in stroke patients, particularly through its relation to stroke severity.
Analyzed data from 891 acute ischemic stroke patients with large vessel occlusion treated at seven comprehensive stroke centers in China from 2017 to 2022.
Calculated hypoperfusion intensity ratio (HIR) using perfusion imaging based on Tmax delays and established a threshold for poor tissue-level collaterals (TLC).
Employed mediation analysis using R to explore causal relationships between HIR, baseline NIHSS score, and FR outcomes.
Futile reperfusion (FR) occurred in 320 (35.9%) of the patients analyzed.
Inadequate tissue-level collaterals (TLC) were linked to a 47% increased likelihood of higher NIHSS scores (adjusted OR 1.47; 95% CI 1.12–1.93; P=0.006) and an 87% higher rate of FR (aOR 1.87; 95% CI 1.31–2.68; P=0.001).
Twenty percent of the link between HIR and FR was mediated by the NIHSS score (95% CI 5.5%–40.9%).