Key result
Pre-intervention six-item scale predicts futile recanalization after endovascular therapy with ~76% accuracy.
Why the study?
Over 50% of patients with large vessel occlusion and large core infarction fail to achieve favorable outcomes despite successful reperfusion after endovascular therapy, necessitating predictors of futile recanalization.
Can a pre-intervention six-item scale predict futile recanalization at 90 days in patients with large vessel occlusion and large core infarction undergoing endovascular therapy?
Observational (n=146)
Can a pre-intervention six-item scale predict futile recanalization at 90 days in patients with large vessel occlusion and large core infarction undergoing endovascular therapy?
Answers are grounded in this paper and cite their sources.
A novel six-item pre-intervention scale can effectively predict futile recanalization in patients with large vessel occlusion and large core infarction undergoing endovascular therapy, aiding in risk stratification.
BACKGROUND: Despite successful reperfusion after endovascular therapy (EVT), over 50% of patients with large vessel occlusion (LVO) and large core infarction fail to achieve favorable functional outcomes, termed 'futile recanalization'. This study aimed to identify predictors and develop a scoring system to predict futile recanalization in patients with LVO and large core infarction undergoing EVT. METHODS: Patients were selected from the Acute Anterior Circulation Large Vessel Occlusive Patients With a Large Infarct Core (ANGEL-ASPECT) trial. Futile recanalization was defined as a modified Rankin Scale (mRS) score of >3 at 90 days despite successful reperfusion (extended Thrombolysis in Cerebral Infarction scale ≥2b). Participants were divided into futile (mRS >3) and no-futile (mRS ≤3) recanalization groups. Multivariable logistic regression was used to develop the predictive scale, with model performance assessed via a receiver operating characteristic (ROC) curve and Hosmer-Lemeshow test. RESULTS: Of 146 patients, 74 had futile recanalization. A six-item scale (0-6 points) was developed, including gender, age, systolic blood pressure, admission National Institutes of Health Stroke Scale score, blood glucose, and neutrophil-to-lymphocyte ratio. The scale showed good predictive performance (area under the ROC curve (AUC) 0.806, 95% CI 0.737 to 0.876) and good calibration (Hosmer-Lemeshow test, P=0.837). The optimal cut-off value of the scale was ≥3 points with 81% sensitivity, 70% specificity, and 76% accuracy. CONCLUSIONS: The pre-EVT scale could effectively predict 90-day futile recanalization before EVT, providing a valuable tool for clinical decision-making and risk stratification in patients with LVO and large core infarction.
No takes yet. Share an insight, caveat, or question.
Gan et al. (2025) conducted an observational in Acute ischemic stroke with large vessel occlusion and large core infarction (n=146). Pre-intervention six-item scale was evaluated on Futile recanalization (modified Rankin Scale score >3 at 90 days despite successful reperfusion) (AUC 0.806, 95% CI 0.737-0.876). A pre-intervention six-item scale predicted 90-day futile recanalization after endovascular therapy with an AUC of 0.806 (95% CI 0.737-0.876) and 76% accuracy at a cut-off of ≥3 points.
Synapse has enriched 10 related papers. Consider them for comparative context: